left shoulder coronal view
left shoulder sagittal view
left shoulder axial view
The next week, while I was cooling my heels in the doctor's office, I took a look at the MRI report which was open on a computer screen in the exam room. Here's what it said:
Examination: MRI study of the left shoulderThe MRI photos mostly looked okay to me, but what did I know? I had looked at some rotator cuff tears online already, and the bad ones had a lot of white areas. Mine only had some small white areas. So that was encouraging. But reading that I had a partial tear was alarming, and I feared the doctor would recommend surgery.
History: Left shoulder weakness and stiffness with history of earlier injury
Technique: Axial coronal and sagittal T1 and T2-weighted images of the left shoulder are reviewed.
Findings: Hypertrophic changes are seen around the acromioclavicular joint with small amount of fluid in the subdeltoid bursa consistent with bursitis and mild changes of tendinitis involving the most anterior portion of the supraspinatus tendon. There is a small partial articular surface tear involving leading edge of the infraspinatus tendon with adjacent synovial cysts seen at the base of the humeral head. The rotator cuff is intact and no abnormalities are seen in the biceps tendon which is located normally in the bicipital groove. Glenoid labrum is preserved. No fractures or bony contusion is seen. No bony destruction is identified. Normal study otherwise.
Conclusion: Mild degenerative changes acromioclavicular joint with subdeltoid bursitis and tendinitis in the supraspinatus region.
2. Partial articular surface tear of the leading edge of the infraspinatus tendon.
In fact, she did not. She told me that I almost certainly had adhesive capsulitis, and recommended physical therapy. I asked about the partial tear - wasn't that a concern? No, she said, it will eventually heal on its own. She also brushed aside the concerns I raised about the bursitis and tendinitis described in the report, saying that my main problem was adhesive capsulitis, end of story. At some point she also said something like "well you don't have any tendinitis" and I had to correct her, having read the report myself. (As you might imagine, my confidence in the doctor was not swelled by her remark.)
So two months after first seeing a doctor for the problem, I was on my way to PT. A good month of the delay was my own fault, and I wish I had not procrastinated so much.
I was able to obtain a copy of the MRI images free of charge, which was sweet. It's fun to run them as an animation, and I hope to create an animation for a blog post, but for now I've just posted one each from the different views. I wish the doctor had gone through all of the images with me. I'd like to know what parts of the image indicate the partial tear, bursitis and tendinitis.