Originally Posted by HoneyBee

On July 26, I got my arm stuck between my driver's seat and the center console while driving (I know - real stupid). I had to yank on it several times to get it out, and the last yank was really hard (I literally almost had to call 911 to have it extracted - the space I was stuck in was about 1/2 inch wide). I ended up going to the dr. 3 weeks later, and have been going ever since ... I've had x-rays, was in PT and taking pain meds, and finally had to go for an EMG and 2 MRIs because I'm still in horrible pain. The pain is mostly in the top of my arm (it feels like those muscles), and in my shoulder. The EMG showed no "damage" and that I had Carpal Tunnel Syndrome (which I already knew I had). It was at some point after starting PT that my arm started tingling and going numb while doing certain movements, and I noticed I couldn't fully turn my head to the right - I get so far, then I get the pain shooting down my arm (that's why I was sent for the EMG and an MRI of my shoulder - I had the MRI first, and the Dr. who did the EMG asked if it was of my neck, too, because it sounded like a "nerve root" problem, but it wasn't, so I had to go back for a 2nd MRI, this time of my c-spine).

After all of this, at my most recent visit (5 days ago), my Dr. stopped the PT (which I had been going to for about 4-5 weeks, or maybe 5-6), continued me on the pain med (which I was allowed to start taking 2 at a time a week and a half ago because the pain was so severe and excruciating), he added a muscle relaxer, told me to get and wear a soft neck collar, and I have to go back to see him in 2 weeks. I had noticed a slight improvement by that last visit, in that I could turn my head further to the right than previously .. but now, 5 days later, I'm back to where I was before with my neck (there's no pain in my neck at all, it just always shoots down to my shoulder/arm, although my upper back feels sore and tight sometimes, too).

MRI of my Right Shoulder: ("IMPRESSION" only)

1. Partial bursal surface and intrasubstance supraspinatus tendon tear
This is a superficial tear, one which most likely does not require surgery
2. Partial interstitial infraspinatus tendon tear
This one is a little more complex and it is a partial tear. Since it is a tendon it will not repair itself. Only surgery can repair it. However it says it is only partial and does not give a grade to the tear which normally indicates it is minor
3. Superior labral tear
This is probably where your pain is coming from, basically it holds the joint together and it will "pop" in and out of place due to this and the only cure is surgery.
4. Acromioclavicular joint arthrosis w/hypertrophic spurring effacing the supraspinatus
This means the area where all of these go through is not as big as it should be and it has bone spurs that are rubbing against them. Sometimes this is the cause of the tear or failure.

I hope I explained it well enough to cover the above and below questions. Now that being said, does it HAVE to have surgery, no. Could it be a surgical candidate, yes. It depends on how badly it bothers you pain wise and range of motion. It will also have the tendency to become worse as you use the arm more frequently. A specialist will talk to you about this I am sure!
My questions on this MRI of my shoulder are:

1. Is there any way to explain all of that in terms I can understand? I understand that the supraspinatus and infraspinatus are tendons (the MRI said the subscapularis and teres minor are normal, and there is "no tendon rupture of retraction"). But what does it mean that it's the "bursal surface and intrasubstance" (in #1), and that it's the "interstitial" infraspinatus tendon (in #2)?

2. From #4, is "arthrosis" different from "arthritis"? (because I do have rheumatoid arthritis, though not very advanced, and osteoarthritis somewhere, but not sure where, and for over a year now I have suffered with extreme stabbing shoulder pain - in both shoulders - that comes and goes, mysteriously, and can last anywhere from 1 week to 4 months, which my rheumatologist does not seem to think is RA - so would "arthrosis" indicate that it IS from RA or OA, or is it caused by something different? I have been a typist/wordprocessor for the last 18 years - so maybe it's caused by poor posture, etc.?).

3. Also from #4, what does "hypertrophic spurring effacing the supraspinatus" mean?


MRI of my Cervical Spine: (for this one, I will give both the "Findings" and "Impression," because the "Impression" was really only 1 thing, yet there's a whole lot more "descriptions" of the individual vertabra given in the "Findings," that I'd like to know exactly what they mean)

FINDINGS:

There is straightening of the normal cervical lordosis which may relate to muscle spasm and/or degenerative changes. Otherwise, vertebral body heights and alignment are maintained and the interspaces are intact. Facet joints are intact. Craniocervical and cervical-thoracic junctions are intact. No acute displaced fracture, traumatic malalignment, compression deformity, or destructive osseous lesion is present. Prominent posterior bulging is seen at C4-C5 and to a lesser degree at C6-C7. Spinal cord is otherwise normal in signal intensity and morphology on the sagittal sequences. Visualized posterior fossa structures are unremarkable. Mildly prominent scattered non-specific cervical lymph nodes. Otherwise, prevertebral and paraspinal soft tissues are grossly unremarkable given lack of intravenous contrast.

At the C2-C3 level, there is no significant central canal or neural foraminal narrowing.

At the C3-C4 level, there is a broad-based posterior disc osteophyte complex and bilateral uncovertebral joint hypertrophy resulting in no significant central canal or neural foraminal narrowing.

Bone spurring/overgrowth not really harmful here

At the C4-C5 level, there is a broad-based posterior disc osteophyte complex resulting in complete effacement of the ventral CSF (cerebrospinal fluid) space and mild mass effect upon the ventral aspect of the spinal cord. No significant neural foraminal narrowing is identified.
Another bone spur here that is actually touching the spinal cord could be something to keep your eye on
At the C5-C6 level, there is a broad-based posterior disc osteophyte complex and bilateral uncovertebral joint hypertrophy resulting in mild bilateral uncovertebral and facet joint hypertrophy resulting in mild bilateral neural foraminal narrowing and near complete effacement of the ventral CSF space with minimal mass effect upon the ventral aspect of the spinal cord.
More bone growth again touching the cord, slightly narrowing the opening where your nerve roots exit.
At the C6-C7 level, there is a broad-based posterior disc osteophyte complex resulting in moderate effacement of the CSF space with no significant neural foraminal narrowing or mass effect upon the spinal cord.
Bone growth yet again
At the C7-T1 level, there is no significant central canal or neural foraminal narrowing.

IMPRESSION:

1. Straightening and slight reversal of the normal cervical lordosis centered at C4-C5, with multi-level posterior disc bulging and uncovertebral joint hypertrophy, resulting in varying degrees of neural foraminal and central canal narrowing as detailed above. No obvious focal disc herniation.

2. No acute fracture or traumatic malalignment.


My questions on the MRI of my Cervical Spine are:

1. What, exactly, is a "bulging" disc? Is it the same as a "herniated" disc? And will these eventually go away on their own?
They are different! They can go away.

2. What is a "broad-based posterior disc osteophyte complex"?
A bone spur that has grown the width of the disc sometimes also called a osteophytic bar
3. What is "bilateral uncovertebral joint hypertrophy"?
bone growth on both sides of the uncovetebral joint

4. What does "complete effacement of the ventral CSF space" mean?
The cord is surrounded by fluid and suspends in the middle of it, this means that it has pushed far enough into the area to touch the cord
5. What does "mild mass effect upon the ventral aspect of the spinal cord" mean?
As a whole for that area it not very big and does not have major effect upon the cord.
6. What is "mild bilateral neural foraminal narrowing and near complete effacement of the ventral CSF space"?
Bilateral means both sides- the foraminen are the openings in the bone that the nerves exit after they branch from the cord. That opening, which is already small, just got smaller.In addition to it affecting both sides it affects the center as well and is touching the CSF Space. Sometimes that is called the ventral thecal sac, the thing that holds the CSF.

7. From the "Findings" section - it says, "Mildly prominent scattered non-specific cervical lymph nodes." I know that "non-specific" means, basically, that "they don't mean anything" (just because they're there). But if it means nothing, or if it's "normal" that they are showing up, why is the radiologist bothering to mention them? Are lymph nodes usually mentioned on MRIs when seen? Or, does it actually mean something that he is saying that they're "mildly prominent"? I only ask because on any blood tests I get, my WBC count is usually elevated, (not to any great degree, I don't think) but the doctors always say that it's normal for my condition (having RA). But i don't think I've ever read anywhere that it's also normal to have "mildly prominent lymph nodes" with RA .. There's been other things going on (with my body) that I've been questioning, and have even gone to an endocrinologist for, so I am just wondering if I should, indeed, have my PCP check into that, or if it truly "doesn't mean anything" that they were mentioned.
They mentioned them because they showed up on the imaging, eaning they are larger than normal. Might mean nothing due to the fact that you have RA and it is an autoimmune disease and will cause elevated WBC's and possible enlarged lymphs.

I know this was pretty lengthy, but I thank everyone who reads the whole thing, and can help me with any answers! The dr "repeated" what the MRIs said, but didn't fully explain it all, and I read the reports myself when I got home, but my next appt isn't for 2 weeks, so that's why I haven't asked my doctor any of these specific questions yet. I did ask him (regarding the "bulging" discs): "Did I do that to myself???" because it's kind of hard to believe ... but he didn't really give me an answer ....