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Hi All-

My son has been complaining of aches and pains as long as he's been sick. Recently the popping, cracking, and creaking has gotten to a scary decibel level. I took him to the orthopedic and apparently he has TWO labral tears- one in his shoulder (pretty common) and one in his hip (pretty rare.) He's subluxed these joints repeatedly and the tears to the labrum have resulted. They require surgery to repair :angry: Mack is pretty upset as his summer, possibly the next two summers, will be ruined.

He has to have two separate MRI's with contrast for diagnostic purposes. Apparently, doing both areas at once is too much dye for his kidneys to handle so the MRI's will be a week apart. Is this OK? Do we have a stronger reaction to the dye? Does 2 injections in 6 days seem like too much? Any experiences with this? I'm being a worried Mom :blink:

Thanks-

Julie

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I have not had this test but may have labral tears. Make sure you get multiple opinions and go to the top people. Labral repairs on hips are relatively new. In the context of a connective tissue disorder, it becomes even trickier. I think there are only five surgeons in the country people really trust to get this right.I saw one of them at Barnes, there's someone in NYC, and someone else in Colorado.

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Julie, So sorry to hear about Mack! Danny had a torn shoulder labrum about 2 years before he began having POTS symptoms. I don't have any advise about the contrast, but I can tell you that acupuncture helped tremendously in his recovery after surgery.

These kids don't ever seem to get a break, do they.

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I had a labral tear in my hip about 10 years ago. I had a hip arthroscopy with debridement of the labral tear. It is important to get an experienced surgeon bz while it is not an extremely invasive surgery, the hip joint is so tight it is difficult to work within the joint. Because I waited so long to have the surgery, I had developed a lot a weakness which resulted in a more prolonged recovery. But overall, it wasn't too bad.

I've also had rotator cuff tears in both of my shoulders which both required surgery. I wonder how it's all related.

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I've had at least 5 hip MRIs with contrast, lidocaine and steroids injected each time. Unfortunately, none of my hip pathology showed up on any of my MRIs. I ended up having a labral tear, dented femur and a ruptured ligamentum teres. I did have POTS prior to all of these injections and had no adverse reaction.

My injuries are most likely from a car accident, not from any other illness.

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From what I understand, part of the issue is whether they return the torn part, or try to repair it. Recovery is longer with repair. I think some of the docs, like Dr.Clohisy at Barnes, look to make sure that there is no underlying malalignment of the bones that would predispose you to tears. If so, they like to reposition bones, and that's a big surgery. And if you add any connective tissue instability, it makes the whole thing trickier, esp as he might have to be on crutches for the hip, which would be hard on shoulders!

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Oy Vey-

I should have realized- nothing is easy for us :rolleyes: .

Mack's serum creatinine is low: .96. I was told he would be injected with " contrast dye." I think we'll go ahead and get the MRI's done & then share the results with Dr. Rowe at Hopkins so that he can advise on what to do.

I was hoping to have this done locally... For those of you who've done the surgery, is is a long recovery/big deal?

Thanks-

Julie

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  • 1 month later...

Hi there. I am new to this forum and just found the questions regarding MRI contrast media. Prior to becoming incapacitated with dysautonomia, I worked in medical imaging for 20 years. I realize this response is likely too late, but I'd like to add that the iodinated non-ionic contrast media used in CT and diagnostic Radiology is chemically different than the gadolinium contrast used in MRI imaging. GFR assessment of kidney function is calculated from the serum creatinine to determine if a patient's kidneys will be able to tolerate either contrast media. There are established recommendations for patients with known kidney disease (3rd stage or higher)who require imaging. Iodinated contrast media used in CT and Radiology can temporarily lower kidney clearance, and this can be an issue with patients on oral diabetic medications, such as glucophage. Gadolinium MR contrast is typically associated with fewer reactions than iodinated CT contrast, except for patients in known renal failure. As a sidenote: if one has an anaphylactic or anaphylactiod reaction to iodinated CT contrast media, there is a premedication protocol that can mitigate reactions to future CT contrast media injections.

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Thank you, DG. It helps to have an expert on board :) . I realize I never updated this thread. Mack got through the MRI's and injections just fine. He was quite ill (with vomiting) during one, but was able to hold it together in the tube- phew. (Nothing to do with the procedure.) We got the greatest news. He apparently has NO tears in either shoulder or hip. His orthopedic surgeon said he has the "loosest" ligaments of any patient he has ever seen. He couldn't believe there was no tearing. No surgery- dodged that bullet!!! :D

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Julie,

I guess I'm too late to add that I went into shock with the iodine contrast dye they used for a CT scan, and to make sure they did the right protocol before he did the scan, and to have plenty of Benadryl on hand in case he had a reaction.

I'm so happy things worked out for Mack, and that your summer should be more fun!

Jana

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