 
                            Could Shoulder Pain Mean A Torn Labrum?
 
 
                                    
                                    
                                          
                                               Posted on
                                          
                                            
                                         
                                           Wed, 10 Sep 2014
                                           
                                        
                                        
                                        
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                                             Wed, 10 Sep 2014
                                                
                                            
                                                Answered on
                                                
                                                Wed, 10 Sep 2014
                                                
                                            
                                                Answered on
                                             
                                             Sat, 4 Oct 2014
                                                
                                                
                                                Last reviewed on
                                                
                                                Sat, 4 Oct 2014
                                                
                                                
                                                Last reviewed on
                                             
                                            Question : Can you still have a torn labrum if the mri didnt see it an you still have shoulder pain an the Obrien test is postive ?
                            
                                    Brief Answer:
Yes, MRI can miss labral tear.
Detailed Answer:
Hello,
Yes, MRI can miss labral tear.
In cases where MRI is done on lower tesla/strength machine.1.5 tesla and 3 tesla machines are better in picking up tears.
In addition MRI arthrography can further increase chances of picking up a occult tear.
You can get a second opinion on current MRi images or other option is to get MRI with or without shoulder arthrography done on higher strength machine.
Other Approach:- if MRI is not showing tear but Obrien test is positive , then even taking empirical conservative treatment for labral tear is good and justified approach.
Hope this helps.Please ask if there are doubts.Regards.
                                    
                                    
                                    
                                    
                                    
                            Yes, MRI can miss labral tear.
Detailed Answer:
Hello,
Yes, MRI can miss labral tear.
In cases where MRI is done on lower tesla/strength machine.1.5 tesla and 3 tesla machines are better in picking up tears.
In addition MRI arthrography can further increase chances of picking up a occult tear.
You can get a second opinion on current MRi images or other option is to get MRI with or without shoulder arthrography done on higher strength machine.
Other Approach:- if MRI is not showing tear but Obrien test is positive , then even taking empirical conservative treatment for labral tear is good and justified approach.
Hope this helps.Please ask if there are doubts.Regards.
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Chakravarthy Mazumdar
                                  
                              
                                          
 
                                    
                                    
                                 
  
 
                                    The surgeon said my mri is good but said it could be wrong to since i still have pain an the Obrien test was postive i have another appointmen next month an if i have pain still he may do surgery what do you think he may do?
                                
                            
                                    Brief Answer:
Try physiotherapy and conservative treatment.
Detailed Answer:
In that case try physiotherapy and conservative treatment for one month.
And if pain continues after that then get MRI arthrography done at centre where there is 3 tesla MRI machine. If it shows tear then only I will support decision of surgery.
Most doctors wont support surgery unless there is definite evidence of tear.
But generally with regular MRI machine if the tear is not seen, we can assume that its a small tear and its very likely that pain will subside in month's period.
Do ask for good conservative treatment and physiotherapy.Avoid any physical activity or strain on your shoulder.
Hope this helps.Please ask if there are doubts.Regards.
                                    
                            Try physiotherapy and conservative treatment.
Detailed Answer:
In that case try physiotherapy and conservative treatment for one month.
And if pain continues after that then get MRI arthrography done at centre where there is 3 tesla MRI machine. If it shows tear then only I will support decision of surgery.
Most doctors wont support surgery unless there is definite evidence of tear.
But generally with regular MRI machine if the tear is not seen, we can assume that its a small tear and its very likely that pain will subside in month's period.
Do ask for good conservative treatment and physiotherapy.Avoid any physical activity or strain on your shoulder.
Hope this helps.Please ask if there are doubts.Regards.
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Chakravarthy Mazumdar
                                  
                              
                                          
 
                                    
                                    
                                 
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