Last Updated on January 31, 2023 by Andre Panagos M.D.
Dot is a New Yorker whose passion is swimming.
She has a long history of shoulder pain that never got in the way over decades of swimming. In early September of 2013 she had a severe attack of right shoulder pain that went on for several months. Her diagnosis was shoulder impingement syndrome which lead to progressive fraying and tearing of the supraspinatus tendon. She attributed the pain to more frequent swimming sessions.
Her pain was so bad that it impacted her ability to carry items and lie on her right shoulder while sleeping. The pain even woke her up at night.
Learn more with this short video on shoulder impingement syndrome
Imaging
September, 2013- MRI right shoulder noted a severe supraspinatus tendinosis at the insertion on the humerus with a focal full thickness tear (yellow arrow).
September, 2013- A right shoulder ultrasound evaluation noted tendinosis and a partial to complete tear of the supraspinatus tendon (red arrow) and bony irregularity (blue arrow) indicating tissue overload and incomplete healing for many years.
Management
Early September, 2013- Several sessions of physical therapy severely exacerbated her pain so she had to stop.
September, 2013- Ultrasound-guided supraspinatus tendon insertion corticosteroid injection- slightly helpful but not with longstanding improvement.
Platelet-rich plasma therapy
Late September, 2013- Platelet-rich plasma procedure into the right supraspinatus insertion with 50% improvement after several weeks.
Early October, 2013- Platelet-rich plasma procedure into the right supraspinatus insertion with a total of 90% improvement after several weeks with an eventual return to swimming.
December, 2015- The patient remains pain-free. A follow-up ultrasound image of the supraspinatus tendon noted increased tendon thickness (red arrow) and decreased bony insertion irregularity (blue arrow) which is associated with the healing process.
A very grateful patient
