English Please

[Jack Moroney (RIP)]

Can one of you med types tell me what this means in English

There is a well corticated calcification projecting in the soft tissues at the acromiohumeral articulation. Additionally noted is well corticated irregularity of the greater tuberosity. There is calcification contiguous with or adjacent to the lateral aspect of the acromion process which could be secondary to degenerative change with ostostoses versus calcification within the rotator cuff. There are degenerative changes at the glenohumeral articulation with subchondral sclerosis and osteophyte formation inferiorly. Findings would be consistent with calcific peritendinitis in the left shoulder. Degenerative change of the left shoulder. There has been progression of these findings compared to the prior examination 1993.

[SF_BHT]

Getting OLD!!!!

[18C/GS 0602]

Sir-

It sounds like you have several areas in your shoulder where the ligaments and tendons have become calcified. This is typically seen due to minor trauma, repetitive use, and possibly genetic and dietary factors. There is also evidence that the shoulder has gotten a lot of use i.e. degenerative change. When compared to the x-ray taken in 1983 things have gotten worse. Hope this helps.

[Cynic]

I'm just an R.N., but I suggest that taking Motrin and applying a moist heating pad to the shoulder might be helpful to relieve acute discomfort.

However, if the calcification has grown worse over a long period of time without relief of symptoms I'll bet the doc wants to do a shoulder arthroscope. Unrelieved shoulder pain can result in a "frozen" shoulder.

My household orthopod is out of town this week or I could give you some statistical pros and cons.

Bottom line, talk to your doc.

[lksteve]

It sounds like my right shoulder...wait...it could be my left shoulder...

It's medicalese for too many years with too much weight in the ruck, too much football, parachuting and, in general, fun having...

In short, SF_BHT hit it right on the head...

[Jack Moroney (RIP)]

Thanks. I've asked for an ortho consult.

[shr7]

Sir-

I am just a pharmacy student, and for the life of me, I could not tell you the difference between a femur and a bicep. However, the ex-girlfriend is a PA student fresh out of anatomy class, so I'll tell you what she had to say. It was also real nice getting a massage out of it as she was showing me where all of these articulations and processes are. I can't tell you any sort of diagnosis or treatment, but I can go through that statement and break it down.

For starters, here is a link to the bones of the shoulder, it may help to understand where things are:

http://www.shouldersolutions.com/anatomy_2.php

This sounds like someones interpretation of an x-ray. The shoulder includes the scapula, the humerus, and the clavicle. The scapula includes the acromion process (the "top of the shoulder, you can feel the edge of it by pressing in beneath the clavicle), and the glenoid fossa (which is the part that "connects" with the humerus), among other parts. A well corticated calcification sounds like some sort of bone formation that has been developing for some time and is pretty permanent. So you have some sort of bone growth into the acromiohumeral articulation (articulation = joint), which is the area between your arm and your acromion process. They also state that there is some sort of irregularity of the greater tuberosity, which is the section of the humerus where the tendon to the bicep attaches, but they do not go into depth about that. These first two sentences are "big picture", and the rest goes more into detail.

The next sentence means that the calcification is like a continuation of the bone around shoulder, probably restricting movement. This injury is probably due to ostostoses (I could only find it as ectostosis) which is the gradual replacement of cartilage with bone. It is probably not the rotator cuff injury that they thought it might be, but the x-ray seems to indicate that it is this ectostosis, instead.

The next part talks about the glenohumeral articulation, which is specifically the joint/space between the humeral head and the glenoid fossa, or basically the ball-and-socket. The subchondral sclerosis and osteophyte formation speak to the degenerative wearing away of cartilage and bone formation in its place. This would be different from an acute injury, where the cartilage would be damaged or squished. Instead, it is wearing away, and bone is forming in its place, probably causing a painful joint.

The next sentence seems to indicate the diagnosis, "calcific peritendinitis ", or calcium deposits forming around the tendons causing the sheath around the tendons to become inflamed. They just finish up with the fact that this seems to be degenerative damage, and not some sort of acute injury.

The ex tells me that that the shoulder would probably feel stiff, painful, and tight. Acutely, you could have a "frozen shoulder" where it is painful and has a very limited range of motion, like you can't get your arm over your head or behind your back. This seems to be what brings most people in to the Dr.

I am useless as far as any helpful information goes, but I hope when you go in and see the Dr. you have some ammunition and know what is being written about you. I can't help with any treatments or first hand knowledge, but I'm sure the MDs/DOs can be of far more use.

SR

[Jack Moroney (RIP)]

Originally Posted by shr7

I am useless as far as any helpful information goes, but I hope when you go in and see the Dr. you have some ammunition and know what is being written about you. SR

Thanks, that pretty much sums up what I have been able to chase down on the internet. Thank your friend for me.

[Doczilla]

I'll be happy to help, Sir. Please don't think me condescending in any of my comments here, since I'm not sure what you are already familiar with, and there may be others reading this who are less familiar with these conditions than you. It looks like you are reading your shoulder MRI, with suspected issues of your rotator cuff. SHR7 has already provided some great info.

Originally Posted by Jack Moroney

Can one of you med types tell me what this means in English

There is a well corticated calcification projecting in the soft tissues at the acromiohumeral articulation.

This is essentially a bone chip in the shoulder joint, but may also reflect an injured tendon or piece of the cartilage or ligaments of the shoulder that has been injured. Calcium deposits will occasionally form in these tissues when injured, forming a "calcification" that we can see on xray. The fact that it is well corticated (rounded off) means that it has probably been there for quite some time, and does not indicate an acute injury.

Originally Posted by Jack Moroney

Additionally noted is well corticated irregularity of the greater tuberosity.

It sounds like at some point you have had an injury where 3 muscles of your rotator cuff insert into the humerus (Supraspinatus, infraspinatus, and teres minor). Again, since it is corticated, it probably is not recent, or may even be something that is congenital and has always been there. Given the other findings in the MRI, it is likely from chronic or remote acute injury.

Originally Posted by Jack Moroney

There is calcification contiguous with or adjacent to the lateral aspect of the acromion process which could be secondary to degenerative change with ostostoses versus calcification within the rotator cuff.

Your rotator cuff is a set of four muscles that holds the shoulder in it's socket when you move it. The acromion is the projection of the shoulder blade that forms that bump on the top of your shoulder where it joins the clavicle. It appears that you have some calcifications here, indicating previous rotator cuff injury. The other option is that you have some arthritis of this joint between the acromion and clavicle (AC joint). Acute inflammation here is often felt when you bring your arm all the way across your body to touch your other shoulder.

Originally Posted by Jack Moroney

There are degenerative changes at the glenohumeral articulation with subchondral sclerosis and osteophyte formation inferiorly.

You have arthritis of the shoulder joint in the "ball and socket" portion of the joint. This part says that the surface of that joint under the cartilage (all joints have cartilage as a kind of cushion) is irregular instead of smooth like it should be. You also have formed some tiny "spurs" of bone just on the bottom of the shoulder joint, which is an indication of arthritis.

Originally Posted by Jack Moroney

Findings would be consistent with calcific peritendinitis in the left shoulder. Degenerative change of the left shoulder. There has been progression of these findings compared to the prior examination 1993.

You've had inflammation of the tendons around the shoulder joint at some point, and calcifications formed as a result. These seem to involve tendons of your rotator cuff muscles. You also have arthritis in that shoulder. It looks worse now than it did 15 years ago.

There is no mention of "impingement", which means limitation of movement of the shoulder. Usually this is a result of calcifications and osteophytes around the shoulder in areas where the tendons slide.

I hope this helps Sir.

'zilla

[Jack Moroney (RIP)]

Originally Posted by Doczilla

I hope this helps Sir.'zilla

Yes it does, thanks. My problem has always been stubborness and choosing to work through the pain. I guess this is an indication that payback has been occuring all along and it is time to pay the piper.

[CoLawman]

Okay Okay my two cents worth! It sounds like you were the victim of one too many arm bars during your grappling days.

[mac117]

it's one of the Itis brothers......named Arthur!

[Jack Moroney (RIP)]

No actually it is a combination of things. Had the MRI, it is a deep tear in the rotator cuff, calcification of some tendons, a bone chip, old age, and the "itis".

[greenberetTFS]

Originally Posted by Jack Moroney

Yes it does, thanks. My problem has always been stubborness and choosing to work through the pain. I guess this is an indication that payback has been occuring all along and it is time to pay the piper.

JM,

Too many checks,boarding and allocations in our youth. I'm going thru the same s*#t myself.......

GB TFS

[Boomer-61]

I'm an ortho PA. If you like, PM me with your symptoms and treatment options.