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Reply To: Clinical diagnosis for shoulder labrum vs. rotator cuff

Exit forum ID Forum Discussion Clinical diagnosis for shoulder labrum vs. rotator cuff Reply To: Clinical diagnosis for shoulder labrum vs. rotator cuff

#8049

Doc Nina
Participant

    Hey Brandon,
    If I am understanding your original post on this patient, the MR Arthrogram did NOT show labral pathology? MRAs are very sensitive and specific for diagnosing any labrum damage, and it would be unlikely for there to be something there if the radiologist indicated otherwise.

    If you would like you could share the MRI with me, I would need the whole study, through a drop box and I could give you my opinion. I just finished a radiology residency in Southern California, and did rounds with the MSK radiologists at the nations number one trauma center in LA. In our practice here I evaluate all imaging, but have not yet found that any labrum pathology is missed by the original radiologist.

    Further, I am confused as to why you think that orthos, such as Apley’s hold no value simply because the shoulder abduction test was 90% which if I understand Dr. Brady correctly means he can bring his biceps to touch his head bilaterally?

    In my radiology experience working with both MD and DC radiologists I do not agree that we tend to “include what we think you want” so much as we include what is most pertinent and of the most value, and then there are those of us who will include every single finding no matter how incidental or mundane it may be. But a labrum pathology is not something myself, or any other MSK radiologist would leave out if it was there.

    Feel free to contact me at drnina@barefootrehab.com if you would like me to take a look at the MRA.

    Cheers!
    Doc Nina