Reel by MBR Health

MBR Health@mbr_health

This is a 42 year old man who was involved in a motor vehicle accident eight months ago. Since then, he’s had persistent pain over his right shoulder that radiates down into his right hand. He’d already had multiple scans of his shoulder, but nothing had identified the cause. So we performed a wide field of view MRI, imaging from the neck all the way down to the fingers. Here’s what we found. On the contrast images, you can see this bright white area here. That’s enhancement, which is consistent with granulation tissue, part of the body’s healing response. In this case, it appears to be related to tearing of the muscles that attach to the ribs. Ongoing healing in this area may explain the persistent pain he’s experiencing over the right shoulder. We also identified a second finding. On his cervical spine MRI, this bright white area within the disc represents an annular tear, also known as an annular fissure. When the outer layer of the disc is torn, inflammatory chemicals from inside the disc can leak into the tear, irritating nearby pain sensitive structures and, in some cases, adjacent nerve roots. That may account for the symptoms radiating into his right hand. So instead of one problem, we identified two separate pathologies, both of which correlate with different aspects of his presentation. Having a more complete picture means his treating physician can now consider targeted management options, which may include further rehabilitation, image guided therapies such as PRP where appropriate, or continued conservative treatment depending on his clinical assessment. This case is a great reminder that sometimes the answer isn’t found by looking at one structure in isolation, it’s found by imaging the whole pathway of a patient’s symptoms. See you on the next one! 👋 #mri #mskimaging #shouldermri #msk #mbrhealth

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Zane Sherif@dr_zane_sherifCo-author

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A preview Instagram ships with the post — 9 of 15 public comments.

@drmarkwestaway Legendary. World leader

August 11, 2026 · 1 likes

@rose_watson_artist @sacredsoundvibes

August 8, 2026

@grey.serzh1900 👏👏👏🆒️👏👏👏

August 7, 2026 · 2 likes

@dryburghdebbie I would love to know your opinion on a brain anomaly I have- I’ve been having MRIs for the last 5 years- my neurologist has no idea what’s going on or what it is !

August 5, 2026

@mbr_health We can visualise the pudendal nerve with MRI NerveView. Mesh is very challenging, poorly visualised on MRI. The best cameras would be ct and ultrasound.

August 5, 2026

@shariok Do patients need a referal to see you?

August 5, 2026

@kirraleesherif 8 months!!! Poor guy… well done @dr_zane_sherif

August 5, 2026 · 1 likes

@nickydavo How can this be? Why wasn't a contrast MRI offered to this patient months ago? This is really quite worrying. People are getting results from scans, xrays, ultra sounds thinking everything is fine but it's not. I'm struggling to understand this. Keep up the excellent work @mbr_health .

August 5, 2026 · 4 likes

@life_is_abutterfly Thank you for sharing your expertise at imaging and interpreting ... How are you at seeing the pudendal nerve and its treacherous path ? I send people to Dr Toos in Sydney but I think you would have a few tricks up your sleeve ... Back in 2018 I had a coloured doppler in France that followed the vein flow and any interruption's were deemed possible compressions then all readings compared to other side . It was very accurate when my Surgery was done ... Also pelvic mesh is another material hard to pick up ... How is your expertise with this implant please ?

August 5, 2026 · 1 likes