Is your Abnormal Shoulder MRI Really Normal?

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abnormal shoulder mri

Will your shoulder MRI lead to unnecessary surgery?

Is your abnormal shoulder MRI really normal?  I’ve blogged before on a very scary trend that continues despite the evidence-many things seen on MRI and blamed for the cause of the patient’s pain that lead to invasive surgery are really normal findings. This has shown to be the case with knee MRIs. For years we doctors have chased around phantom meniscus tears while modern studies have shown that an awful lot of patients without symptoms have meniscus tears on their MRI. A recent NY Times piece highlighted a study by an orthopedic surgeon that showed the same thing for shoulder MRI. The study involved scanning the shoulders of 31 perfectly healthy baseball players without pain. Despite imaging normal players, the shoulder MRIs found abnormal cartilage in 90 percent and abnormal rotator cuff tendons in a whopping 87%! I love the quote from the surgeon, “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an M.R.I.” The patient example mentioned in the NY Times story is typical of our experience. This patient went skiing and developed knee pain. An MRI seemed to show a tear in his ACL so two surgeons wanted to yank it out and replace the ligament. The third surgeon told him his ACL was normal on exam and found an occult fracture that was the real cause of his pain. The story highlights a huge problem. Many physicians have abrogated their exam to the MRI scanner and don’t practice the common sense combination of looking at the picture, listening to the patient, and performing a thorough exam. The upshot? We have many patients who come to us transfixed on their MRI as if it were the Oracle from Delphi and many have been told that they need invasive surgeries simply based on the MRI with little exam or history to corroborate what’s on the films. This includes patients who are about to have their entire knee, hip, or shoulder joint replaced but who actually have pain coming from somewhere else. If you’ve had a 5 minute evaluation where much of the time was spent transfixed on the MRI and very little was spent asking about the who, what, when, and where and on a good old fashioned exam, you may need a second opinion!

Most Tears in the Rotator Cuff don’t cause Symptoms

How Accurate is an MRI for Diagnosing Hip FAI?

Finally a Way to Tell if that Meniscus Tear on MRI is Really causing Pain

MRI of the Knee in Soccer Players-Interpret with Caution!

Shoulder X-ray Findings not Related to Pain-No Surprises Here


Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
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Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
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Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
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Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

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