AVN in Shoulder

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Hello,

9 years ago I developed an autoimmune disease known as Pemphigus. The treatment is prednisone. Six years ago I started choosing foods according to the blood type theory, and was able to stop taking the prednisone 5 years ago.

It now appears that I have AVN in my right shoulder, a probable result of the side effects of the prednisone. At this time, I've had 1 MRI which reveals the necrotic area to be approximately 2cm in diameter. I have chronic low grade referred pain in the deltoid area and loss of range of motion.

Other history: I have numerous osteoma's throughout my body that apperently formed while I was on prednisone. I became aware of them 3 years ago, and since that time, they have not grown or changed. I know I have them in my jaw, elbows and thighs; perhaps other places as well.

Questions:

1) Most of the occurances of AVN appear to be in the hip. If I have AVN diagnosed in the shoulder, what is the probability that I also have it in my hips, and is an MRI justified?

2) Are there any surgeons you are aware of who have expertise in core decompression of the shoulder? I live in a small city in Oregon, so I would either have to travel to have the surgery or have the physicial consult with my local orthopedics physician.

3) Is anyone aware if acupuncture or other energy based alternative medical modalities have been experimented with to determine if capillary/nerves can be stimulated to grow in the necrotic areas, or be of benefit after core decompression surgery?

4) It is unknown when the AVN developed. How long should I wait before MRI's to determine if it is still decaying? Given that the current dead area is 2cm in diameter (I am a small framed person, 5'7", 135lbs), should I wait for a second MRI or consider having the core decompression as a prophylactic against further decay.

thank you,

Steve Shapiro Eugene, OR USA

-- Steve Shapiro (steve_shapiro@orsa.uoregon.edu), April 06, 2004

Answers

Steve,

I also have AVN in the shoulder - and for the pains in other joints - my doctor did rule out AVN first. I think that is always on our minds - that it might be in other joints as well. So far hips and left shoulder have been ruled out.

As for the cd - that is a personal choice I do believe. Some can handle the pain better than others. Mine is about the same size as yours 2x2x0.5 - but at the same time, I also have a lot of pain in that shoulder. I still work daily at this point - and I really would like my quality of life back. As I am a single mom - raising a teen ager at this point - so lots to do.

Wish you best of luck - no matter what you choose.

Barb

-- Barb Susanto (runningdeer@rew2000.com), May 13, 2004.


I have bilateral AVN due to decompression injury (The Bends). For about two years after the original infract (vessel blockage and bone death) I had full function. I started working out and got pretty severe pain in both of my shoulders. Turns out that the bone was intact but weakened. The bone collapsed, no more than a cm, but enought that I want my ROM back w/o pain. I will have CD in the end of June. Told the pain is significant for a few days. I feel it's worth it if it can re-istablish the blood flow and heal. My orthopedic doctor said it's a relatively simple thing to do.

My first MRI was October follow up seven months later. Accupunctur might help with symptoms, but bloodflow might well heal it.

-- Mark Roesler (markroesler@hotmail.com), May 26, 2004.


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