肩部MRI報告分析及治療建議-復健科

肩部旋轉肌撕裂？

您好，以下是我的右肩MRI報告. 疼痛狀況已有4-5個月. 本人目前在美國. 骨科醫師曾經局部施打類固醇, 但是打完後更痛. 約一個禮拜才逐漸減輕. 只是疼痛又回來了. 目前正在復健中. 治療師要我做了許多強化背部肌力的運動. 治療師另外指出我有一點翼狀肩. 復健治療有一點效果, 但是緩慢.肩部目前可以抬舉的高度並無很大的限制. 只是偶爾有痛感. 向背後延伸(類似抓癢)痛感較明顯.雙肩在轉動時都會發出聲響.(多年前騎車發生車禍, 左肩直接落地)FINDINGS: The acromioclavicular joint demonstrates minimal superior and inferior osteophyte The infraspinatus tendon demonstrates some diffuse increased T1 signal laterally, nonspecific tendinopathy. On the oblique sagittal images at the anterior aspect of the infraspinatus insertic a short segment articular surface partial width tear is seen measuring 4 mm in anterior posteri dimension on sagittal image #19. This articular surface partial width tear extends less than 50 of the depth of the tendon thickness. The supraspinatus tendon also demonstrates some diffus increased T1 signal, nonspecific tendinopathy. The teres minor attaches normally. The subscapularis tendon attaches normally. The long head of the biceps tendon is normal in position within the bicipital groove. The biceps anchor is intact A prominent biceps labral sulcus is seen, but the superior labrum is intact. The anterior labrum, posterior labrum, and inferior labrum are intact The axillary pouch and inferior glenohumeral ligaments are intact In the posterior aspect of the humeral head superiorly subchondral cysts are seen. IMPRESSION: Nonspecific tendinopathy lateral aspect of the supraspinatus and infraspinatus tendons. At the insertion anteriorly the infraspinatus tendon demonstrates a short segment articular surface partial width tear. Early degenerative changes are seen in the acromioclavicular joint.想請問:1) 我的骨科醫師當下並沒有提出需要開刀, 只說要是再有無法忍受的疼痛可以找他打消炎止痛.但是依照您復健科的專業這種情形是否需要到開刀的程度?2)除了持續復健/打針與口服消炎藥外還有其他可以嘗試的治療方式嗎?3)您是否建議同時找復健科醫師尋求其他治療方謝謝！