: Injury Report:
Burrows may miss part of season
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06-15-2010, 08:31 PM
Join Date: Jul 2005
Originally Posted by
"Because medicine isn't a science"
- Dr. Spaceman, 30 Rock.
But seriously, because these things aren't black and white. I know certain posters like to portray the Canucks as chronic mis-diagnosers, but the fact is, it often takes multiple examinations to determine exactly what an injury is, not to mention how severe it is, and then it's
not always clear what the best course of action for repairing it is. Sometimes waiting to see how the body responds really is the smartest choice.
This is what Google tells me:
The best tests available to make the diagnosis of a labral tear are magnetic resonance imaging or a test called a CT-arthrogram ( the latter is a CAT scan preceded by an arthrogram where dye is injected into the shoulder). Both of these tests are relatively good at defining a labrum tear due to a subluxation or dislocation, but they are only around 80-85% accurate. For that reason, some physicians believe that are not always needed if the diagnosis of subluxation or dislocation can be made by history and physical examination. Neither of those tests is currently very good at making the diagnosis of a SLAP lesion. This area is very complex and it is difficult to reliably get good pictures of this area with MRI.
However, if the MRI definitely shows a tear then frequently it will be present. The problem is that the MRI may miss smaller tears and cannot reliably make the diagnosis in larger tears of the labrum.
The best way to make the diagnosis of labrum tearing is with arthroscopy of the shoulder. Unfortunately this is an operative procedure and requires some form of anesthesia. Making the diagnosis also takes some experience on the part of the surgeon, since the anatomy of the inside of the shoulder can be quite complex. The relationship between labrum tears and symptoms has not been totally figured out, so it is not clearly known which ones should be repaired and which ones can be left alone.
According to Gillis on the radio today, the tear turned out to be worse than they thought. I'm guessing they originally thought he didn't need surgery.
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