Tears of the Rotator Cuff Part 2: Identifying Tears on MRI

Рет қаралды 40,149

Күн бұрын

Пікірлер: 39

@SEROBERT 5 ай бұрын

Very helpful for a non radiologist - will help me show an inquisitive patient their partial supraspinatus tear on their MRI. Thanks so much for your clear and excellent presentation

@JeffreyWittyMD 4 ай бұрын

Thank you for the comment. Glad it was helpful!

@Guru-qd2cm 11 ай бұрын

this is the best video that clearly shows exactly what happend in the shoulder. Thankyou so much. I am going to surgery in a week time for 2 full tears and 2 partial tears in my right shoulder. I also have 1 full tear and 1 partial tear in left shoulder but my surgeon focused mostly on right shoulder. Thankyou again

@JeffreyWittyMD 11 ай бұрын

I typically focus on the shoulder with more tearing as well before returning to work on the other shoulder. Good luck with your surgery!

@animallover-lc2zh 19 күн бұрын

So, I saw the other video of an MRI of the rotator cuff, which was excellent, by the way, and wished you made one of an actual tear. Well, I found it!! Here it is!! And it's as good as the other one. Very clear explanations. Excellent descriptions. Just wish that little + sign of a cursor was bigger or brighter or different. Sometimes it's hard to follow.

@JeffreyWittyMD 17 күн бұрын

Thanks for the feedback. I have wondered about the cursor and thought the same thing. I'll make it bigger next time.

@hhspore Жыл бұрын

wow this is amazing explanation and presentation. I can fully understand what you are saying even though I am a lay person. Thank you doctor for sharing this very useful video. This helps me to understand the MRI images that my surgeon went through with me two weeks ago. I finally made the decision to go for shoulder replacement instead of rotator cuff repair due to the massive full thickness complete tear that I had on my supraspinatus and subscapularis even though I do not fit in the age profile of the shoulder replacement classification. Singapore

@Judyslife1969 Ай бұрын

Thank you so very much for your thorough and precise explanation It really helped me to understand my shoulder problem. I've been going to therapy for a month after suffering a lot of pain for six months, but without an MRI he hasn't really been able to diagnose my shoulder problem. He doesn't think I have a total tear but.... I will be getting an MRI this week. Thank you again.

@JeffreyWittyMD Ай бұрын

I'm glad you found it helpful!

@dt5413 Жыл бұрын

Thank you! I have an MRI tomorrow for both my shoulders. My left is the most painful. I always get a copy of the MRI & look at all the images. It’s very interesting to me. I have Ankylosing Spondylitis & other spine issues so I’ve had a lot of MRIs. This is going to really help me understand my injury if it is a cuff tear.

@elkhazaid6171 7 ай бұрын

Thank you very much for that precise and derailed explanation , it really help me to understand my IMR ..

@JeffreyWittyMD 7 ай бұрын

Glad it was helpful!

@WorldCommander 10 ай бұрын

This makes the RC pathology and MRI understandable. Hope to see video of some subscap repairs too. Excellent. Thank You.

@JeffreyWittyMD 9 ай бұрын

Glad it was helpful!

@1zixen 4 ай бұрын

Thank you Dr. you did the much better job than my surgeon explaining this to me. I haven’t done the surgery yet, but this certainly help me to decide if I need to do surgery or not.

@JeffreyWittyMD 3 ай бұрын

Patient education is critical when making a decision about surgery. Good luck!

@margaretmeaker2830 10 ай бұрын

Thank u - enjoying this - finding it quite intriguing. Thanks for ur time compiling these videos

@nikhilunnava 11 ай бұрын

Great explanation in detail ! Thank you .

@griddog1 8 ай бұрын

Very helpful, thank you.

@ColorTheDesert Жыл бұрын

Thank you so much for your videos, super helpful

@mfadzli10 11 ай бұрын

Thanks so much Dr, frm Malaysia...Really appreciated the content..tomorrow going for mri for shoulder

@JeffreyWittyMD 11 ай бұрын

Best of luck!

@1stNeoSpartan 5 ай бұрын

This is legit. Thank you

@EricBandar 2 ай бұрын

excellent teaching

@JeffreyWittyMD 2 ай бұрын

Thanks again!

@mikecar52 5 ай бұрын

Thank you.

@d.noname3608 Жыл бұрын

What does the real roator arthrscopy looks like!!! ??? SEries please!!

@JeffreyWittyMD Жыл бұрын

I hope to get that out asap!

@aidaheidari2917 Жыл бұрын

It was great👍, plz make a video about MRI of minsci and ACL tear with detailed explanation like this video🙏🙏 we are looking forward to seeing it😉

@JeffreyWittyMD Жыл бұрын

Not a bad idea... I'll start to work on it!

@jaspersanfellipo7184 Жыл бұрын

Thank you for posting such an informative video. Very helpful. Here's an surgery question: how do you determine the number of anchors you place during a repair? I've seen videos where 3 anchors are placed and where 1 anchor is placed--both for a full-thickness tear. Apologies in advance if one of your other videos addresses this question.

@JeffreyWittyMD Жыл бұрын

Great question. I just finished up a video on the anchors we use and I didn't specifically address this. There are a lot of different ways to fix a rotator cuff tear. As you can image, the tendon can tear many different ways. There are many other variables to consider when determining the type of repair. Some of these include the pattern of the tear, size, quality of tissue and others. There are situations where a particular surgeon's 1 anchor can accomplish the same as another surgeon's 3 anchors. In general, we will put an anchor for every 1 - 1.5cm of torn "footprint" from the bone. Again, this is a generality and I personally believe it's best to adjust the repair to the type of tear. You want to find the right balance between fixation / strength of the repair and putting too many holes in the bone for anchors. The type of repair that is best has been debated for many years in the orthopaedic surgery literature.

@jaspersanfellipo7184 Жыл бұрын

Thank you for the informative response. I can imagine there are lots of variables at play that an experienced surgeon--like yourself--can't predetermine from an MRI. Needing to make a decision once you see what the quality of the tissue makes sense. Thanks again for this channel. @@JeffreyWittyMD

@justbrowsing5279 Ай бұрын

Is this from a shoulder MRI or does an MRI that's intended to diagnose rotator cuff injury have to be performed from a different angle or position. I have several symptoms of rotator cuff injury but an MRI of my shoulder was apparently normal. I have read that certain things like teres major injuries are often not seen on shoulder MRIs because of the field of view. Any clarification would really help. My symptoms are killing me and have been getting worse for months. Positive lift off test and pain from internal rotation have me thinking subscapularis or teres major but obviously I'm no expert. The shoulder specialist I saw told me muscles in that area never tear in someone my age. I'm 47 and felt it happen during weight lifting exercises that were all rotator cuff centered.

@JeffreyWittyMD 28 күн бұрын

justbrowsing5279, A "shoulder" MRI should be able to pick up the vast majority of rotator cuff tendon problems - if not all of them. That being said, it can be hard to see certain types of tears. You bring up an interesting point. Your description of pain (lift off test etc) as you say could be a sign of subscapularis tearing. Subscapularis tears can be hard to pick up on a MRI. You can see them but you have to be looking very closely and often looking for other indirect signs of the tear. It is very possible you have a subscapularis tear and its just not being recognized. Given your weight lifting injury (bench etc but really any similar motion) another consideration is a tear of your pec major. This would not be seen on a shoulder MRI because the pec tendon inserts further down and out of the field of view of the shoulder MRI. We usually have to order a "chest MRI" and often specify our concerns to the MRI tech / radiology team to make sure they get the appropriate area. Partial tears of the pec major can be very difficult to see on a physical exam (even when looking for them). A tear of the teres major would be really unusual in my experience but would probably be too far down for a shoulder MRI. 47 years old is not too old to have a tear of the subscapularis or pec major. I respectfully disagree with the person you spoke with if that is what they said. I hope this helps! _______________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.

@WilliamCampbell-hv5zx 9 ай бұрын

Are those last couple of massive tears too far gone for re-attachment surgery.? When do es the option for reattachment close and replacement shoulder surgery become the only viable option left?

@JeffreyWittyMD 8 ай бұрын

Excellent question. There are many variables that we have to consider to determine repairability of the rotator cuff. Some of these include: 1) size of the tear 2) tendon and muscle quality 3) age of the patient 4) retraction of the tendon 5) how much osteoarthritis there already is in the glenohumeral joint As these variables worsen, patient gets older etc, the chance of the tendon healing will diminish even if you can get a repair of the tendon to bone. Just looking at the images in the video in isolation, I would say yes, I think those could be repairable. We have ways we can augment the repairs to help with the fixation of the tendon to bone and to help with healing as well. So, in my opinion, a surgeon should have those available for a case with tears that large - bringing the kitchen sink if you will. _________________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.