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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Shoulder Pain Preventing From Sleeping. MRI Shows Arthritis With Type 2 Acromion. Suggestions?

I have had some significant left shoulder pain waking me up or preventing me from going to sleep. MRI showed the following last week. Moderate arthritis with type 2 acromion . Sever diffuse supraspinatus and infraspinatus tendeionopathy with low grade partial partial thickness articular tear of the anterior leading edge supraspinatus tendon measuring 8x9mm. Mild spurning of the greater tuberose try. Degenerative slap tear. Mild fluid in the subacromial sub deltoid bursa. Small low grade partial thickness tear of the subsapularis tendon insertion 5x5mm. What does this mean? What are my chances of not having surgery? I have been doing PT for a week now and doing that hurts even at 5 pounds doing external rotation. I used to do 25 pounds on external rotation.
Mon, 22 Jul 2013
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Orthopaedic Surgeon, Joint Replacement,  's  Response
Hi, thanks for writing to HCM.

All the findings in the description suggest ROTATOR CUFF ARTHROPATHY with DEGENERATION.

* ACROMIO CLAVICULAR JOINT(ACJ) ARTHRITIS - An asymptomatic ACJ does not require treatment even if the MRI is positive. The initial treatment for this problem is by ACTIVITY MODIFICATION by avoiding movements that puts strain on the joint and ANALGESIC MEDICATIONS. If the pain is very severe, then a STEROID INJECTION into the joint will provide good relief.
If everything fails, then an arthroscopic or open distal clavicular resection is advised.

* MANAGEMENT OF ROTATOR CUFF TEARS - If a tear is partial and small , conservative treatment is tried which includes analgesic antiinflammatory medicines and PHYSIOTHERAPY to strengthen the rotator cuff muscles and scapular stabilizer muscles. If there is no improvement, then an ARTHROSCOPIC REPAIR may be needed.

Consult a good arthroscopic surgeon in your locality and follow his advice.

Hope this information is helpful. Good day
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Have Shoulder Pain Preventing From Sleeping. MRI Shows Arthritis With Type 2 Acromion. Suggestions?

Hi, thanks for writing to HCM. All the findings in the description suggest ROTATOR CUFF ARTHROPATHY with DEGENERATION. * ACROMIO CLAVICULAR JOINT(ACJ) ARTHRITIS - An asymptomatic ACJ does not require treatment even if the MRI is positive. The initial treatment for this problem is by ACTIVITY MODIFICATION by avoiding movements that puts strain on the joint and ANALGESIC MEDICATIONS. If the pain is very severe, then a STEROID INJECTION into the joint will provide good relief. If everything fails, then an arthroscopic or open distal clavicular resection is advised. * MANAGEMENT OF ROTATOR CUFF TEARS - If a tear is partial and small , conservative treatment is tried which includes analgesic antiinflammatory medicines and PHYSIOTHERAPY to strengthen the rotator cuff muscles and scapular stabilizer muscles. If there is no improvement, then an ARTHROSCOPIC REPAIR may be needed. Consult a good arthroscopic surgeon in your locality and follow his advice. Hope this information is helpful. Good day