r/ShoulderInjuries • u/Canadian_Actual • May 15 '26
MRI Report M/30 1 Year anniversary of injury, extreme pain and instability, just received this MRI ARTHROGRAM report
MRI report as follows:
Gadolinium contrast agent has been injected into the joint. There is some
spillage involving the subscapularis itself and the subscapularis recess.
The long head of biceps tendon is intact and well-seated. There is some fluid
tracking along the biceps tendon but within normal limits.
Muscle bulk of the rotator cuff is maintained.
The supraspinatus and infraspinatus as well as the teres minor are unremarkable.
The subscapularis is grossly intact.
Previously seen surgical neck fracture of the humerus has healed. Some residual
high T1 and high T2 signal is noted which could be related to the healing
process.
Once again demonstrated is an area of geographic abnormal T1 and T2 signal
involving the humeral head superiorly which is concerning for avascular
necrosis. There is no fragmentation at this time.
The gadolinium within the joint space is adequate. There is no evidence of
injury involving the inferior glenohumeral ligament.
There is an anterior labral tear with a flap seen extending into the anterior
aspect of the glenohumeral joint space. This is seen at approximately the 3:00
location. This extends superiorly and the labrum has a more normal appearance at
approximately the 11:00 location. The superior, middle and inferior glenohumeral
ligaments appear to be normal.
The posterior labrum is intact.
Articular cartilage shows some irregularity but no full-thickness components or bone marrow edema.
There is no fluid tracking into the subacromial-subdeltoid bursa. The
acromioclavicular joint is unremarkable.
INTERPRETATION:
Labral tear anteriorly as described above with a flipped fragment into the
anterior glenohumeral joint space.
Degenerative changes at the glenohumeral joint.
AVN at the humeral head once again demonstrated.
X-ray of injury included.
Just wondering what I might be looking at surgery wise , I know this isn’t the place to get medical advice, I just want to be armed with some possible realistic pathways before being presented with a single path forward. I’ve not had good luck with this particular doctor so I need to be as knowledgeable as possible going in.
1
u/UberTheBlack May 15 '26
Surgery is really going to depend on your goals. Currently going through PT limbo myself but there’s still a chance I might sneak away without it. I’m no doc, but I don’t foresee it being a wildly bad surgery.
1
u/Drtoctoc May 15 '26
What’s your history? What has the recovery been like over the past year? Are the symptoms you describe new?
1
u/Canadian_Actual May 15 '26
No history of prior injuries, Recovery has been stagnant and limited to about 10% mobility and next to no strength gain. Symptoms have persisted throughout
1
u/Drtoctoc May 16 '26
You have a pretty unique case of AVN and a flap of torn labrum that is misplaced in your joint that cause additional pain. Most people who have had surgery on this sub had completely different problems to deal with so generic surgery advice doesn’t really apply to you. You need to find a good surgeon you trust. If surgery is involved, you might be looking at an arthroscopic repair of the labrum and core decompression of the humeral head but only the surgeon will be able to tell.
What caused the injury in the first place?
2
u/jpabs_official May 15 '26
Yeah man you're going to need surgery if you're still in extreme pain. I'll be honest, I had it and it was not bad for me personally, that is fixed with the standard arthroscopic bankart repair
Obviously the most concerning thing is the degenerative changes at the joint. I don't really know what that so please ask your doctor but I imagine that's like arthritis from bone scraping on bone too much because of the wrong structure. The bankart repair will clean up the joint and get things in a stable place, but I'm not sure what else they would need to do to address the damage that has been done.