Understanding Your Shoulder MRI Report - Part 1

Please note there is an updated version of this video which has been edited for better visualization of the actual MRI reports and terminology. It can be found at this link:
• Understanding Your Sho...
In this video we will review 3 cases of actual patient MRI reports. We will go over the terminology in the report and explain what it actually means in (hopefully) easily understandable terms. The findings on the MRI reports in this video tend to be more typical of patients in their 40's, 50s, 60's and older so keep this in mind when watching the video.
For reference, here is a list of some of terminology that is mentioned in the reports:
Chondromalacia
Subchondral cystic change
DJD
Marrow signal / Bone marrow signal
Labral Degeneration
Tendinopathy / Tendinosis
Footplate
Muscular atrophy
Subacromial
Subdeltoid
Bursitis
Partial/complete/intermediate etc type tears
Tendon retraction
Musculotendinous junction
Long head biceps
Intra versus extra-articular
Humeral head “spur”
Subcoracoid
Synovitis
AC joint (Acromioclavicular Joint)
Arthropathy
Muscle atrophy
Effusion

[@HeyIntegrity]

1.Does distal subscapularis tendinosis mean thickening ot thinning of the tendon? is it also from the articular to bursal like top to bottom or like how much of the tendon? 2. The glenohumeral joint effusion means the fluid/inflammation is of the anterior or posterior joint capsule or where is it located? For ex. if there is tear involving the superior glenoid labrum with degenerative changes to the posterior labrum. The remainder of the labrum is intact. The biceps labral complex appears intact. A small joint effusion is noted. 3. is it possible with mutiple intrasubstance tendon tears that heal and reinjured that the tendon can be shorter? 4. Is MRI only telling us what muscle fibers are present right now. if someone lost muscle fibers from past severe injuries or disease would it show on MRI?

[@JeffreyWittyMD]

Thanks for the question. 1) Tendinosis can actually make the tendon swell and thicken. With wear and tear over time the tendon can also thin out. So the answer to your question is both. You can have changes to the tendon along the articular, bursal or inside the tendon itself or the entire tendon as a whole. 2) Think of the joint like a deflated balloon. When you start filling it with water the balloon inflates and the water is pretty much in every space of the balloon. That's pretty much how a joint effusion develops. So if you have a tear in the posterior (back) of the shoulder joint, the fluid will just accumulate through the entire space. 3) The tendon can shorten with injury, tendon retraction after a tear, and as time transpires from the time of injury. 4) I'm not sure I understand the question but I will try to answer. Usually muscle fibers won't just disappear even with severe injury. The injury may cause muscle atrophy which is essentially when the muscle shrinks in size. However, there can be fatty infiltration of muscle (in particular the rotator cuff). This is when fat tissue will start to accumulate in between the muscle fibers as they atrophy. In particular this happens when the tendon of the rotator cuff starts to retract. _________________________________________________________________________ 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.