mri for rotator cuff tear

Now the results of the MRI:                                

1.High-grade partial-thickness tear at the articular surface fibers of the supraspinatus tendon measures approximately 7x13mm.  The tendon involving approximately 75% of the tendon thickness.  No atrophy or fatty infiltration in the suprainatus muscle.                                   

2. severesubacromial/subdeltoid bursitis.                                                 

3.  Mild osteoarthritis of the glenohumeral joint.                                         

4. interesting no mention of the rotator cuff. 

My additional concerns see bottom of this..

Jan 18,  had the MRI done at the public hospital  for the Rotator Cuff Tear as had been approved by their risk managment back in Dec.  Since the Dr. did not put stat or urgent on the order, was given a month away.  Now instead of the pacemaker  mfg. rep. coming.  The MRI techs are trained for some of the mfg.'s Medtronic is one of them.. He told me not all mfg's are willing to have them do the resettings.

Had no trouble putting my pacemaker to sleep.  Showed on his Ipad it said now ready for MRI.    It was after the MRI where it became scary.  The puck  that he put on the pacemaker, would not read.  Kept showing low battery.  Fortuantely they found another one. And that one read an turned me back on.  Glad the tech was honest and told me the problem. While waiting thought how would I really know that it had not be reset.  Am not pacemaker dependant.  I did not have my glasses on so could not see the screen.

Said please make sure they are charged when i am back on Monday for the Spine  MRI.

MY concerns have written to my cardiolgist.  What happens if they do not have additional readers?  How do i know they have put the pacemaker back in the right settings.

new to pace


6 Comments

Worrying experience

by Gemita - 2024-01-19 04:00:47

New to Pace, I am so sorry to hear about this. It should not have happened.

For your safety in an MRI environment, certain conditions must be met.  A qualified pacemaker technician would need to place you in a safe mode for the duration of the MRI scan and then restore your settings afterwards.  These are, in my opinion, basic requirements for "safely" having an MRI scan with an MRI conditional pacemaker and leads.  Even though you are not pacemaker dependent, you were still dealing with a potentially dangerous situation.  

Did you go to a large centre of expertise, a centre where they carry out MRIs frequently on pacemaker patients?  My concerns would also be related to whether the puck with a failing battery had adequately placed you into a safe mode before the MRI too?    

As to your question "What happens if they do not have fully charged pucks readily available and how would you know they have put the pacemaker back to the original settings?"  

(1) they would have to urgently request a puck from Cardiology or another department or if they noticed the battery problems before your scan and could not guarantee the successful placement of your device into a safe mode, they would not have been able to carry out the procedure (2) if your settings have not been properly restored to their former values, you would start getting symptoms like before you received your pacemaker, more arrhythmias perhaps too, so if you are symptom free, this might be a good sign? 

When the technician places us into a safe mode before we receive our MRI, they should keep a record of all our original settings, what changes are made, so restoration of settings after an MRI should be accurate.  In particular, they should have done a download of your data/settings beforehand so that any ill effects of your scan can be properly assessed afterwards.  Did the puck have enough power/energy to do this successfully, I wonder?  How safe were you during the MRI?  This is why many MRI technologists refuse to carry out scans on pacemaker patients without a qualified cardiac technician being present at all times.  

I would respectfully request a full pacemaker check be made to look for any potential damage to your device, leads, data;  maybe a chest X-ray to check position of your device and leads too.  I would respectfully request a full explanation of what exactly happened and what can be done to make sure that something like this never happens again?

Medtronic chest reader

by piglet22 - 2024-01-19 05:10:38

Interesting to read that there were problems with the pacemaker chest reader (puck) and charging.

This is similar to the reader on the home monitor MyCareLink (MCL).

Normally in clinic the reader is hard wired to the base unit and battery charging isn't an issue 

Medtronic obviously have a problem with the design of the reader and my MCL reader wouldn't charge leading to a lot of faffing around getting it changed.

Many devices from cordless phones to torches use the same system of charging where the device sits in a cradle and relies on the weight of the device to make a good reliable contact.

There are several reasons why this is poor practice especially in a medical device. The connection relies on moving parts and more importantly on contacts that remain clean and free of oxidation. Gold plating is required for long term reliability. The MCL reader is not which is why it fails in as little as one year.

It's basically design on the cheap.

In an emergency, you can try a mild abrasive (Autosol) or a glass fibre pen, on the contacts, or adding weight to improve contact.

Ultimately, it will fail again.

There are other things that can be done, but I wouldn't recommend them.

It does question whether the move to remote monitoring is wise and if an iPad in a clinical setting instead of hard wired is appropriate.

New to Pace

by piglet22 - 2024-01-19 05:25:08

You are right to be concerned.

It's bad enough having to go through MRI but then have the added stress of equipment failing.

The puck has a built-in lithium battery and relies on proper charging, plus someone making sure that everything is working properly.

Sometimes new methods aren't the best and probably none of this would have happened with the older hefty fully wired equipment.

Finding out the battery isn't charged at the critical moment is not good.

I fear that this is the sort of thing that is going to ripple out to home users.

I too have raised my concerns with the local MP.

was put into safe mode before MRI

by new to pace.... - 2024-01-19 07:44:47

In answer to your question Gemita, yes i was put into a safe mode first.  Could see it on the Ipad that was used.  I was able to read that i was ready for the MRI.

  That said did feel a thumping on the left side of my neck.  It was the first time i felt that .  Believe it was because they had put something over the pacemaker. First thing that was put on was heavy so asked them to remove that and then they put a lighter something over. Since it was the left shoulder for the MRI and not much space to work from.

Since i am remotely checked every night, if there is a problem am sure i would hear from the Heart office this morning.  Will say i slept hard and on my back last night.  Was the first time in a while that i slept the whole time.

I have had many MRI's since the implant of the pacemaker(2019) and this was the first time with this problem.  Did say to the tech before i left to make sure the pucks are charged over the weekend.  As am back on Monday for my spine.  Also this was done at our Public Hosiptal in the Radiology Dept.

new to pace

Concerning

by Lavender - 2024-01-19 09:38:48

Mary,

I would request a complete pacemaker check at your regular clinic after Monday's MRI is completed. I truly hope they figure out what to do to help you with your shoulder and back issues. 
 

 

pacemaker check

by new to pace.... - 2024-01-19 10:04:03

Lavender, I seem to be ok this morning.  The shoulder  MRI was for the Rotator Cuff tear from a year ago.  I believe it has healed since i now can reach across  my back to  scratch my back and tuck in my tank top and blouse.  All done without surgery.  Have been treated with accupuncture, occasional botanical  and B12 shots.

The spine is to see how old some of the fractures are and any new ones along with the strength of the bones.  Am currently taking K2 and D3.  Cardiologist said it was ok to take the K2. First doctor said yes to surgery, 2nd said no surgery until i heal the osteroporsis .

new to pace

You know you're wired when...

You have a $50,000 chest.

Member Quotes

At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!