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Old 10-07-2009, 09:00 AM   #1
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Need help understanding son's MRI results on shoulder injury

Fluid in the subclavicular region and AC joint Effusion. Bone marrow contusion suspected in the medial humeral head.

No definite rotator cuff tear. No evideace of lumbus tear.





I'm glad we don't surgery. But my son is saying the pain is horrible and he can's sleep at night. I would know he is waking me up almost every night. The doctor told the nurse to tell to me to give him motrin every 8 hours for pain. After 2 hours of school he's calling and saying the motrin is not working anymore. I really do not know what to do. Any opinions would help

 
Old 10-08-2009, 09:02 AM   #2
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Re: Need help understanding son's MRI results on shoulder injury

number one, i would take him back to that doc and demand that he be re evaluated, THEN ask him to please give him something more appropriate for what i know would be a pretty good level of pain, just based upon that humerous being bruised at all? bone pain is some of the worst with a non stop achey throb that just kind of sits there till the body absorbs the bruise and hopefully that effusion. while motrin is a good anti inflammatory med, he also obviously just needs something a bit stronger for the more 'acute' type of pain it sounds like he is also having, til this finally really starts to heal.

just exactly how did this injury occur in the first place? he actually has fluid in two seperate places, which is usually from truama in his type of situation. one is in that subscap region(it does not really get too specific tho) and the other is more than likely(the effusion?) an increase in the normal level of what is called synovial fliud which is what lubricates our joints. his joint more than likely was traumatized in some way given the bruising to the head of that humerous too? just knowing the true mechanisim of injury would help alot.

the good news here, and trust me i had a total complete tear of my supraspinatus tendon and a partial tear in the one underneath that tendon as well, the rotator cuff area itself suffered no trears or other issues that can just occur within that whole shoulder area when someone suffers a 'shoulder' injury. also no tears to the labrum, also great news. just so you know, in some cases where the bloodflow is lower like within the are we are talking here? they may have to actually aspirate that fluid out since it wont absorb itself really well in areas with lower blood supply like the knee, elbow, and the shoulder joints. and i really am wondering exactly where in his subclavicular region(pretty general) that fluid is other than what it states in the MRI? is this free flowing or a pocket or what? you know what i mean?

you could try using aleeve instead of the motrin? this is naproxen and still in the NSAID group of drugs so it has the anti inflammatory types of properties just like motrin, but you ONLY have to take it twice a day vs the like every four hours of the motrin? it is just a much longer acting type of med. also, when he is at home,ice ice ice and always make certain when he is actually lying down that the shoulder area is always above his heart to some degree. this just helps it heal faster and keep that throb from being so overwhelming too.

any patient complaining of any type of pain, espescially when it is from a confrimed injury, just has the right to have that pain 'appropriately' addressed. even with children and teens too. something like even tylenol # 3s would probably really help him with the more acute type of pain he is having. this really should have been rxed right from the start after that level of injury was revealed upon the MRI being done. the problem is most docs are simply opiate phobic,and espescially if the patient is a teenager?? just how old IS your son just so i know? who actually gave you the MRI results? was this in an ER or was this a referral only from a primary type doc?

either way,i would take him back in to have this looked at again and see about asking for something to help with what is NOT actually be covered ONLY by motrin. bone pain just hurts. but ice too became my very best friend after that rotator surgery. i had alot of real bone pain that was really awful to deal with just in and of itslef. tho the bones themselves do not have actual 'nerves' they just have to have at least alot of real pain fibers within them in order for the types of some of the most painful procedures like a bone marrow aspiration being one of the most painful??

your child just does need you to really advocate for him right now. he DOES deserve not to have to suffer when it would be just a matter of a doc who gives a crap writing an Rx for something that was just a bit stronger at least til things get better. if his primary doc wont do this one thing for him i would just take him to your local ER when it gets bad(and consider changing your primary here too??). they could also do a CT(or another MRI) too just check on how things are. i need to ask you, is his pain actually getting ANY worse from what it was initially like the first two days? is anything getting better? just how long ago was the injury done to him? knowing the answers to the last questions i just asked is kind of important. i do hope things get better soon. please keep me posted. FB
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11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
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