Not so neat thing.

[Griffin727]

So I haven't shared this fully before, but back in 2018 when I 1st hurt my right shoulder I went to the doctor and had 2 MRI's and 4 xrays over a span of 2 years that showed nothing major. When I finally found a good guy who would do surgery they found a bone mass that was 7mm in subacormal space in surgery. I have a picture of it on my phone. My question is have any of yall ever herd of imaging failing people like this? I ended up seeing 3 surgeons before one stated he thought it was a imaging issue. This went on from 2018 to 2020. Also does anyone know why these masses/ osteocytes form under the acromion in young people? My theory is old fractures, genetics or the coracoid acromion ligament putting traction on the front of the acromion causing a downward slope.

[Mark Rippetoe]

No experience with this. We'll ask the board.

[Will Morris]

So I haven't shared this fully before, but back in 2018 when I 1st hurt my right shoulder I went to the doctor and had 2 MRI's and 4 xrays over a span of 2 years that showed nothing major. When I finally found a good guy who would do surgery they found a bone mass that was 7mm in subacormal space in surgery. I have a picture of it on my phone. My question is have any of yall ever herd of imaging failing people like this? I ended up seeing 3 surgeons before one stated he thought it was a imaging issue. This went on from 2018 to 2020. Also does anyone know why these masses/ osteocytes form under the acromion in young people? My theory is old fractures, genetics or the coracoid acromion ligament putting traction on the front of the acromion causing a downward slope.

Traction spurs are called enthesophytes and they occur at the tendon insertion (less likely at a ligamentous insertion) on the bone. We see them commonly in the Achilles Tendon insertion on the calcaneus, and at the patella, and less commonly at the triceps tendon. Those are caused by chronic traction on the bone.

You have no such structures under the acromion that would be causing a traction spur. So, that leaves you with the likely cause being that you have a genetic predisposition to osteoarthritic degeneration, have a previous injury to that area that caused the disease process to activate, and then you have increased bone turnover and osteoblastic activity that is layering more bone in the area to reinforce the areas that are chronically inflamed.

[Griffin727]

Traction spurs are called enthesophytes and they occur at the tendon insertion (less likely at a ligamentous insertion) on the bone. We see them commonly in the Achilles Tendon insertion on the calcaneus, and at the patella, and less commonly at the triceps tendon. Those are caused by chronic traction on the bone.

You have no such structures under the acromion that would be causing a traction spur. So, that leaves you with the likely cause being that you have a genetic predisposition to osteoarthritic degeneration, have a previous injury to that area that caused the disease process to activate, and then you have increased bone turnover and osteoblastic activity that is layering more bone in the area to reinforce the areas that are chronically inflamed.

I always thought me playing football and hitting without shoulder pads while wearing a helmet from 9 to 17 could have caused it. Good point about arthritis. My left didn't have near the mass as my right which was werid. Thanks for the explanation.

[Griffin727]

Update, so I'll more then likely have to get another subacormal decompression (acromionplasty) on my left shoulder. After a physical exam and reviewing the MRI, they are thinking I have regrown the bone mass that was so called took off 3 years ago. I haven't had any acromion injurie so why am I developing bone in my subacormal space again at the young age of 28? This will be my 3rd shoulder surgery. My right arm is doing great 4 years post op, but my left still pinches even after rehabing and a ton of ibuprofen. Is it possible they didn't electrocauterization properly and bone was able to regrow?