MRI shoulder 20170103 & wrist 20161227
ccc> Full-thickness tear of supraspinatus tendon.
> Partial thickness tear of subscapularis tendon with medial subluxation of biceps tendon long head.
> Focal bicipital tendinosis is noted at pulley level with thickening and increased T2 signal intensity.
> Intact infraspinatus tendon, teres minor tendon.
> Muscle strain of anterior, lateral, posterior deltoid muscles & trapezius muscle with edema and fluid accumulation.
> Large amount fluid accumulation in shoulder joint with extension to posterior upper back.
> Anterior inferior glenoid labral tear, suggestive of Bankart lesion.
> Fraying of bicipital labral complex, suspicious for superior labral tear.
> OA change in glenohumeral joint with spur formation.
> AC joint arthrosis with spur formation & hypertrophy.
> Subacromial spur formation.
> There is type 2 acromion.
CONCLUSION:
> Massive rotator cuff tear and OA change in right shoulder.
> Muscle strains in right shoulder with fluid accumulation.
PS:
> 我覺得SSC 跟你說的一樣是有問題的 => SSC partial tear (裂開)造成 biceps 擠進去SSC (medial subluxation)(S/I: 4/23)
> HX是啥呢? 是車禍或trauma嗎? Muscle strains 很厲害, muscle edema, fluid accumulation (主要在 fascial plane)
> 關節腔的水向後上方延伸, T1沒有高訊號 不像是hematoma or hemoarthrosis 可能就只是水吧?! 還是abscess? (但散散的沒有一包一包的)
> 有Bankart (S/I: 2/14-18 & 4/27)& suspecicious SLAP
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> Radial avulsion of the triangular fibrocartilage at the level of the distal sigmoid notch, in favor of TFCC injury, Palmer classification ID.
> Mild lunate chondromalacia with mildly increased subchondral bone edema, in favor of TFCC injury, Palmer classification IIC.
> Small subcortical bone cysts in lunate and trapezium.
> Normal intrinsic scapholunate and lunotriquetral ligaments.
> Normal carpal alignment and carpal tunnel.
CONCLUSION:
> TFCC injury of left wrist.
PS:
> ID: (S/I: 22/9)
> IIC: (S/I: 22/8)