help me understand this report?

[solson]

Our daughter had an MRI done and the findings reported this:
slight assymetry of the lower cervical spine brachial plexus nerve roots, slightly more prominent on the left.....slight assymetry of the glenoid version angle with the left angle measuring 78 degrees and right angle measuring 9 degrees....findings most consistent with a type II, minimum glenohumeral deformity.

Can anyone help me better understand this? Our doctor at the time just said her shoulder joint wasn't malformed and so we weren't candidates for surgery but I would like to understand the overall report.

[katep]

First, a word of warning. If this report is from a non-BPI specialist, I wouldn't even bother reading it. It most likely isn't worth the trouble.

And are you POSITIVE it says a glenoid version of 78 degrees on one side and 9 degrees on the other? Because that is no way "slight" - that is extreme glenoid malformation. Could it possibly be 7.8 or 7-8 or something like that? The report also doesn't mention PHHA - percentage of humeral head anterior to the glenoid fossa. This is a measurement of subluxation. But if the two shoulders have the same version (ie the above is not 78 but 7.8 or 7-8) then the PHHA should also be normal.

If you email me directly, I can send you a paper that describes these measurements and shows which MRI angles are used to obtain them. You could then get a copy of the MRI directly (it usually comes on a CD with a viewing program also on the disk) and you could double-check the measurements directly against the pictures. I would be happy to help you with that.

Kate

[solson]

Positive on the findings. It was an MRI read report. Our BPI specialist told us that there was no shoulder deformity as he had expected there might be based on the findings.

Is it possible that they were reading her external rotation? Those numbers would make sense.

I'll email you for the info. Thanks for helping.

[katep]

Sent.

I'm guessing it is a typo in the MRI report. I can't think of a measurement that could even BE 78 degrees for a physical measurement in the shoulder. It couldn't external rotation because that is an active measurement, not something that would be read on an MRI. If your specialist said the MRI looked good, I'd just ignore the report. There's obviously something incorrect about it.

Kate

[solson]

The problem is the specialist told us at the time that he hadn't personally reviewed the MRI but had read the report and told us all was fine. So when I saw the report I was confused because those results don't indicate a completely normal shoulder joint. I made an appt. with our orthopedist and am going to get a second opinion from him. I ordered the actual MRI so he can look it over with us. The other weird thing is the report read that her nerves are completely normal. Does it ever happen where the nerves have completely healed but muscle imbalance and contractures remain? I'm really so confused.

[katep]

There is no way that report, as you've typed it, describes a normal joint. It's unlikely that the MRI is going to show much about the nerves unless there were lots of avulsions and even they don't always show up (depends on the MRI). It will be interesting to see the actual MRI. I would be very concerned about any opinion given on your daughter's shoulder by a specialist who didn't view the MRI directly. There is far too much room for major mistakes there. My son's report said "normal shoulder" but he was severely deformed and subluxing. Your typical radiologist doesn't even know how to interpret a BPI shoulder MRI.

Kate