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Forum Name: Degenerative Bone Diseases

Question: AC Joint


 dmamacher - Fri Jan 21, 2005 12:23 pm

I woke from a nap on Christmas afternoon (Saturday) in a severe amount of pain. Although I napped on the couch and didnt really move, the pain was coming from my left shoulder. Since it was a holiday weekend I resigned myself to have to wait until Monday to see a Dr..

Monday morning when I woke, the pain was gone but I had limited movement when it came to certain reaching movements. Wednesday the pain was back, in addtion to the movement problems. The pain stopped by Friday but I was referred to have an EMG. It showed that the infraspinatus and the supraspinatus were "dead" as i call it. There was nothing coming from those two muscles. An MRI shows Hypertrophy of the AC Joint which is causing impingement of the rotator cuff.

I do have Degenerative Joint Disease and have had to have a disc removed at L4-L5 but my question is, can there also be a neurological cause to this? An MRI shows that I have prominence of the ventricular system and mild diffuse volume loss. I have memory problems and my Neurologist found gait disturbances. I am waiting for my appointment for him to go over the several brain MRIs that I've had (TIA related).

I can handle a simple ortho issue but my fear is that its more. Do you have an opinion? I appreciate any feedback you can provide.
 Dr. A. Saif - Fri Feb 18, 2005 12:55 pm

User avatar Dear D,

Sorry about the rather long lag between post and reply, I presume by now you have much of the answers you need.
I will focus on the things you have mentioned that relate to your shoulder
The supraspinatus and infraspinatus are part of the rotator cuff of muscles that attach to the top end of your humerus (the humeral head), and move your shoulder. They can appear dead to EMG is the nerve to them is injured. The suprascapular nerve supplies these and can be damaged by pressure on a particular area of your shoulder. The damage can also be caused by a cyst that presses on this nerve at a particular point on the shoulder blade (scapula). Another reason is a reason is a rotator cuff tear. Iit would have to be quite a big tear, and although can be caused by impingement, I presume the MRI didn't show such a tear. Impingement itself is painful, and requires intitially physio and anti-inflammatories, perhaps a shoulder injection of steroids, occassionally needs surgical decompression...

While TIAs and other neurological conditions that you have mentioned can affect these muscles, the EMG trace would not be "dead", and pain is not normally a feature.

Hope this helps

Saif

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