Imaging in shoulder disorders

Excerpt

Magnetic resonance imaging (MRI) is generally regarded as the gold standard for shoulder imaging. It is well tolerated by patients and comprehensive in evaluating most clinical situations. It is a static examination, often requiring arthrography to optimise diagnostic accuracy in patients with subtle internal derangement, and may demonstrate “incidental” findings leading to potentially erroneous diagnosis and additional investigations. Ultrasound is a focussed examination providing rapid diagnosis and treatment in specific clinical situations. A complete examination of the rotator cuff can be carried out in the time it takes to do one MR sequence. Advantages include immediate clinical correlation, useful observations on soft tissue structures during movement and interventional treatment guidance. Its diagnostic accuracy has not been evaluated as well as that of MRI; stored images are not as easy to review retrospectively and are not as well understood by clinical colleagues. Unlike MRI, ultrasound plays little or no role in the assessment of the articular cartilage or labrum. …