MRI Before Radiography for Patients With New Shoulder Conditions

Small, Kirstin M.; Rybicki, Frank J.; Miller, Lindsay R.; Daniels, Stephen D.; Higgins, Laurence D.

doi:10.1016/j.jacr.2017.02.031

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…The glenohumeral articulation, rotator cuff, biceps tendon, joint capsule, and bony structures as well as the labrum, are all potential sources of shoulder pain. Imaging tests are crucial in the proper identification of individuals with traumatic shoulder pain, working in tandem with a detailed history and physical examination (2) . Rotator cuff impingement and tears are the main causes of shoulder discomfort in patients older than 40.…”

Section: Introductionmentioning

confidence: 99%

Study of Role of Magnetic Resonance Imaging in Evaluation of Non-Traumatic Chronic Shoulder Pain in Adults

Almolla

Elmohamady²,

Khater³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: A highly helpful diagnostic technique for determining the cause of shoulder pain is magnetic resonance imaging (MRI). Objective: To study the role of MRI in the diagnosis of chronic non-traumatic shoulder pain. Subjects and methods: In this cross-sectional observational research, 60 patients (32 males and 28 females) presented with chronic shoulder pain and limitation of movement. All cases were recruited from the Orthopedic Surgery and Radiodiagnosis Departments at Zagazig University Hospitals. All cases were assessed by Magnetic Resonance Imaging. Results: Fifty-three cases had rotator cuff pathologies, thirty-seven cases had acromioclavicular osteoarthritis, twentynine cases had bursitis, fifteen cases had biceps pathologies and nine cases had miscellaneous conditions. A study; 16 (35%) Sub coracoid, 10(16.7%) in Sub-acromial sub deltoid and (5%) Subscapular. Among the current study, 9 (15%) of cases were miscellaneous. Four cases were suffering from interosseous cystic lesions (6.7%) of all cases. Lipoma was seen in 3(5%) of cases. Ganglion cyst was seen in 2(3.3%) of cases. Conclusion: MRI of the shoulders aided in understanding different underlying pathology of chronic shoulder pain and revealed that dependence on only clinical findings and diagnosis could delay their management as well as chronicity development.

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Section: Introductionmentioning

confidence: 99%

Study of Role of Magnetic Resonance Imaging in Evaluation of Non-Traumatic Chronic Shoulder Pain in Adults

Almolla

Elmohamady²,

Khater³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…2 A recent study in a large urban academic hospital found that 33% of patients whose MRI was ordered by a specialist undergo subsequent surgery, whereas this number drops to 18.4% when the MRI was ordered by primary care. 3 Another study showed that, with a well-performed history and physical by an orthopaedic surgeon, supplemented by radiographs, MRI changed diagnosis or treatment in only 18% of cases. 4 In a series of 101 consecutive patients with chronic, atraumatic shoulder pain, pre-evaluation MRI had no significant effect on treatment or clinical outcome.…”

mentioning

confidence: 99%

“…5 Current evidence suggests that, at least as it pertains to shoulder pathology, MRIs should be ordered by or in consultation with an orthopaedic surgeon trained in shoulder pathology and after prior plain radiography. 3 The increasing reliance on advanced imaging is multifactorial. Time constraints in clinics across specialties have led to inadequate teaching of physical examination skills to trainees.…”

mentioning

confidence: 99%

Editorial Commentary: Black Mirror: Reviving the Art of the Physical Exam

Athiviraham¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Ankle MRI and preceding radiographs: an evaluation of physician ordering practices

Noblett

Bateni

2022

Skeletal Radiol

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Objective Multiple guidelines have been published for appropriate imaging in patients with ankle-related symptoms which suggest radiographs as the initial imaging examination for both acute and chronic ankle abnormalities. Few studies have evaluated adherence to these imaging guidelines. This study retrospectively evaluated the utilization of ankle MRI and preceding radiographs based on ordering provider group and MRI indication. Materials and methods A total of 4186 ankle MRIs performed over a 9-year period at a single institution were evaluated for the presence of preceding ankle and/or foot radiographs at two time points, within 3 months and within 6 months of the MRI examination. Ankle MRIs were then categorized based on 6 ordering provider groups and 13 MRI indications. Results Of the 4186 MRIs evaluated, 68% had preceding radiographs within 3 months and 77% had radiographs within 6 months. Primary care, sports medicine, and podiatry had the lowest rates of preceding radiographs (73%, 68%, and 64%, respectively, within 6 months). Eighty-six percent of ankle MRIs ordered by orthopedic surgery had preceding radiographs within 6 months and 89% of ankle MRIs ordered by emergency medicine and inpatient providers had preceding radiographs. MRIs intended for evaluation of Achilles tendon or plantar fascia abnormalities were among the least likely indications to have preceding radiographs. Conclusion Based on established clinical guidelines, there was a lower-than-expected rate of obtaining preceding radiographs for ankle MRIs among most provider groups, particularly non-orthopedic outpatient providers. Additional research is needed to address the lack of adherence to clinical imaging guidelines and ensure appropriate imaging.

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MRI Before Radiography for Patients With New Shoulder Conditions

Cited by 3 publications

References 10 publications

Study of Role of Magnetic Resonance Imaging in Evaluation of Non-Traumatic Chronic Shoulder Pain in Adults

Study of Role of Magnetic Resonance Imaging in Evaluation of Non-Traumatic Chronic Shoulder Pain in Adults

Editorial Commentary: Black Mirror: Reviving the Art of the Physical Exam

Ankle MRI and preceding radiographs: an evaluation of physician ordering practices

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