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Diagnosis: Using Open MR Injection to Confirm an Axillary Nerve Entrapment
Animated at right: Open MR injection for confirmation of the diagnosis of axillary nerve entrapment syndrome.
Pain and weakness in the shoulder is often due to a shoulder joint injury or to rotator cuff syndrome - an injury in which the muscles and ligaments around the joint are weakened or torn. However, in many cases, the actual cause of the problem is an entrapment of the axillary nerve. This condition causes weakness of the deltoid muscle making it difficult to raise the arm to the side. It also causes pain around the outer surface of the shoulder.
After confirming the tentative diagnosis by MR Neurography in a high field scanner, the patient goes to an Open MR system for an interventional diagnostic injection.
A titanium Lufkin needle (*) is advanced to a position adjacent to the area of the axillary nerve which was hyperintense on the Neurography study. Imaging in the Open scanner is by Flash T1 sequences which take about 10 seconds to acquire. The needle causes minimal artifact and appears as a black signal void in the image.
If the diagnosis is confirmed but the problem returns quickly, then the entrapment can be relieved by a small outpatient surgery. This diagnostic method and the treatments for this condition were developed by Dr. Aaron Filler at the Institute for Nerve Medicine.
TOS Information | TOS Diagnosis | TOS Treatment | |||||||||||||||
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Dr. Aaron Filler is the world’s leading expert in treatment of nerve pain. He has revolutionized nerve-pain treatment by inventing several new technologies. One such technology, MR Neurography, enables doctors to use an MRI scanner to examine nerves — previously a difficult-to-impossible tissue to see through MR imaging. Dr. Filler's research in axonal transport is leading to a whole new generation of advanced pain medications. He has developed many new “minimal access” surgery methods that allow him to treat complex nerve problems with small outpatient surgeries. He has also pioneered the use of the Open MRI scanner to do surgeries and other therapies with the ultra-high precision and safety of the magnetic resonance imaging. 
Do You Really Need Back Surgery? by Dr. Aaron G. Filler, MD PhD, is a best-selling paperback every sufferer of spine and nerve pain should read. Written in everyday language, the book is a must-read.