Surgeon doesn’t agree on Ultrasound report
Posted , 6 users are following.
i am 10 months post op suprastanaus repaired. i was doing okay until last week. all of a sudden woke up with stiffness and pain. i waited few days but could improve and rushed to GP and he ordered Ultrasound scan and it showed Full thickness of Subscapularsis tendon and i went to see a surgeon who performed my last surgery today. he examined physically for every angles for all tendons and he thinks everything is okay and told me not to worry but i asked if he can order an MRI for the sake of peace of mind (though he wasnt really willing to do as he thought it was okay ) he was like "i think they have got it wrong". as per my feelings too, my movement is okay and little bit pain but thats always been there anyway since the surgery. Has anyone have any experience about Surgeon not being agreed with the radiologist's opinion ? can ultrasound be misleading ? i really hope they are wrong as i dont wanna go for another surgery .
0 likes, 27 replies
jule93059 Hems06
Posted
An arthrogram sounds like it would be in order. Its not a pleasant exam as they inject dye but its more reliable then a simple MRI
Hems06 jule93059
Posted
thanks . i guess it is just a plain MRI like i had before. Dr didnt mention anything about injection. hopefully theres no damage as Dr believes.
moon53540 Hems06
Posted
Some radiologists can be known to over diagnose, so if you are worried get a second opinion from another radiologist in a different hospital (so there is no biased opinion). Ask for a copy of the ultrasound so you can get a fresh pair of eyes to look at it. You may have to pay for the second opinion though.
Hems06 moon53540
Posted
thanks. Nah, MRI has already been booked for next week. hopefully, theres no problem. i feel it is 50/50 considering my movement, pain and the strength. well, if it was full thickness i wont be able to do anything, i guess.
mike1997 Hems06
Posted
Hello:
Sorry to hear about your issues. I've had several MRI's of both my shoulders and both times the technician who gave the written report of my rotator cuffs seemed to go a bit overboard. For example on my left shoulder MRI the tech said that there was a small tear of my Subscapularis but when arthoscopic surgery was performed the surgeon said there was really nothing there to worry about and he did nothing. He did repair the other 2 tendons (infraspinatus and supraspinatus) though and my labrum.
It's somewhat hard to believe a technichian would say you have a full thickness tear of the subscapularis without ample evidence on the scan. An MRI is a better indicator of what's going on. But it seems there probably is a tear and your surgeon may suggest surgery or therapy.
It sounds like something that has developed recently if there is a tear as when he did your surgery 10 months ago and went in arthoscopically he would have seen other problems including any tears of the subscapularis.
You said he examined you recently. I guess that means he put you through a bunch of tests raising arm in various positions. Those are helpful but not as good as an ultrasound, mri or surgery to really see what's going on. On my right shoulder the mri showed I had a full thickness tear even though I was fully functional and still needed surgery. So those physical tests are helpful but don't really indicate what's going on as well as an MRI.
Here's hoping the MRI confirms what if anything is wrong. Hope all you need is more therapy!
Hems06 mike1997
Posted
hi there, thanks for sharing your experience. yes, Dr examined all the different angles for each tendons. and he was also going through previous scans but didnt see ant tear on Subscapularsis only the Suprastinaus he repaired. yes, i dont mind needing more therapy as long as i dont need to go for another surgery. the worst case would Dr suggesting for surgery since i am still young. i am 31 yo now.
jule93059 Hems06
Posted
A technician is just that, a tech and not allowed to give a medical dx. The radiologist does that.
mike1997 Hems06
Posted
Hi,
Thanks for that correction. I was wondering since the analyst is called a radiologist does that mean there is x-rays you are exposed to during an MRI?
jule93059 Hems06
Posted
no
ED2018 Hems06
Posted
I am going through something similar. Had both shoulders done last year (rotator cuff, bicep tenodesis, acromioplasty and debridement). First shoulder done 4/2018 started to hurt significantly again - after 4 months of exams, steriod shots and continued PT - finally surgeon ordered an arthrogram MRI. Showed a full thickness tear of the supraspinatus (one that was repaired). Scheduled for 2nd sgy to repair 2 weeks from now (Ugh). I would strongly suggest you advocate for the arthrogram component to be added to your MRI as it is the gold standard in Orthopedics to diagnose tears. It is like the difference b/t flash and no flash in photography. If you are going to go to the expense and effort of the MRI - why not make sure it shows ALL of the structures so they can truly figure out what is going on? Surgeons don't like learning their work didn't "take" - but facts are that some of these surgeries fail despite their best efforts. Push for what you need so you don't waste time and prolong your suffering. Wish you the best!
Hems06 ED2018
Posted
thanks and sorry to hear. Surgeon didnt mention anything about arthogram. it is just a normal MRI. well, the shoulder doesnt feel right and i think theres a problem but how bad is the damage. i just hope not much damage is done and i can avoid the surgery. it scares me like a hell remembering about those painful nights. especially first 6 weeks.
jule93059 ED2018
Posted
You are correct. The arthrogram shows more detail and yes, even being so careful and doing what youre told post op, some surgeries fail. The shoulder is complicated. Ive had 2 repairs and now the rt one has failed. Im only 9 wks post op on the left and the pain is terrible
Hems06 jule93059
Posted
thank you. i think arthrogram is not a big thing in Australia. i have never heard of anyone doing it. well, I was told the tendon is attached and can get back to normal activity. and Dr was surprised too seeing the new tendon getting torn( as per US report) so he ordered an MRI. yes, tell me about the pain,it hurts like a hell. i felt better after 12 weeks when the strengthening programs begins, as the muscle starts to get stronger. And frustrating thing is i am just 31yo and i have long way to go, so i cant compromise on any movement. last time Dr said, if i was above 60 he would nt recommend the repair. and i am guessing hes gonna say the same thing. hopefully NOT
jule93059 Hems06
Posted
Im 64 and a nurse. Last year i was 7 mos post op, lifted a heavy patient knowing that i shouldnt and damn if I didnt retear it. Problem is, the left one was worse and I really needed that one done 1st. Needed several anchors. Im 9 wks post op and I WILL NOT lift anyone again. Im so over this. Im still on pain meds, exhausted from not sleeping well and p****d at myself for lifting that pt because I still need to redo the rt one. I think shoulder surgery is the most painful. I'd rather eat glass then go through this s**t again
mike1997 ED2018
Posted
Hello:
Sorry you are having trouble. I was under the impression that MRI's are very helpful in finding out what's wrong but nothing is as good as a good surgeon going into your shoulder and examining firsthand what the problem is. Maybe I'm just lucky? Because in the case of both my shoulders the MRI as interpreted by the radiologist seemed to exaggerate problems or miss other things that the surgeon upon seeing through his arthoscopic surgery was able to define exactly.
I'd love to have a surgeon's input on this.
And if you are correct that the surgeon was unable to see/fix something that the MRI may have missed it may actually be more of a statement on that particular surgeon's lack of skill? Again, I was under the impression that when a surgeon entered your shoulder arthoscopically, that it was a matter of routine that they check out ALL the possible issues going on with your tendons, labrum, biceps, etc.
Again, I'd love to hear what a surgeon has to say about this.
Best Wishes to all!
Hems06 jule93059
Posted
yeah, the pain is terrible. just a question -is it the same surgeon that you have had several surgeries with or different ? anyways, good luck !!!
Hems06 mike1997
Posted
i get your point but what if MRI shows theres nothing problem in the joint ? would any surgeon recommend for a surgery ? i dont think so.