Joe A Shaw PA-C - 7/14/2008

Question
Hi Joe - You had answered a couple of questions I had regarding my shoulder and recent surgery back in March (please see questions on 3/24 and 3/25 for history). In a nutshell, I had subacromial decompression on 3/3, and at that time I was concerned that my biceps pain was returning and had not been addressed by the surgery. It is now over 4 months since my surgery, and my biceps pain is still a problem.

    Here's my question:  I had a non-contrast MRI of shoulder and upper arm on 6/30.  I called the ortho's office for results and he would like me to come in to discuss findings; however, I couldn't get an appointment until 7/25. I have a feeling that I've been having a problem with biceps subluxation, but since MRI is a static test, what might possibly show up? Any ideas on what else might be going on? (I know it's probably impossible for you to speculate, but thought I'd ask anyway.) The thought of there being something there is one thing, but my other fear is that nothing will show and I still will have no answer and no way to resolve my pain. I'm relatively young and athletic, and the thought that I would have to give up things like softball (I can't maintain a batter's stance, let alone swing a bat), swinging a golf club, or tae kwon do, not to mention what is has meant for my job (I'm an RN turned veterinary nurse) has become very disconcerting.

   Once again, thanks for your time, consideration, and expertise.



Sue


Answer
Sue,
Yeah the shoulder surgery pain should be much better by now..so it seems like there is something else going on..the MRI should be able to show any damage or groove problem, but of course it is a snapshot as you say. Were you able to do those bicepital tests to see if they reproduce pain etc?? I would print off that article about the different grooves etc and take it with you..I know some Dr's may blow this off..but as I remember it was from a medical journal all be it from China. Your ortho will probably want to try another cortisone injection but in the B groove area to see if that helps..just to see if it will isolate the problem..ie if you inject lidocaine or marcaine and some steroid into this area does that relieve it some?..then at least you know where the pain is coming from..but not necessarily what is causing it. I guess ck back after you see him and get the report. Maybe it will show something?