Role of MRI in the evaluation of painful shoulder

Abstract

Introduction: Shoulder pain is a common complaint in primary health care resulting in significant pain and disability, loss of productivity and health care costs. Magnetic resonance imaging (MRI) has played an increasingly important role as a noninvasive test for determining the patients of shoulder pain which may benefit from surgery. Aim and Objectives:The study is done to demonstrate the role of MRI in detecting shoulder pathologies encountered in patients of shoulder pain. Methods: The study included 50 patients referred for MRI Shoulder after a detailed clinical workup. Images were acquired using various non-contrast enhanced sequences and were analyzed for pathologies. Results: Among rotator cuff tendon supraspinatus tendon was most commonly involved (64%).Tendinosis, partial thickness tear and full thickness tear of supraspinatus tendon was revealed among 36%, 26% and 2%. In case of Subscapularis and Infraspinatus tendon; partial thickness tear and tendinosis was reported among 4%, 8% and 2%, 4% of the subjects respectively. Acromio-clavicular arthropathy and labral tear was found among 32% and 18% of the subjects respectively. Most common bony pathology was Hill Sach lesion (10%) followed by Humeral Head Cyst (6%) and Joint Effusion (6%). Impingement was present in 8% of the subjects. Discussion: MRI is the preferred test for evaluating impingement syndrome and rotator cuff pathology. Conclusion: Magnetic resonance imaging is an excellent modality for imaging pathological processes of the shoulder joint. It has benefit of non-invasiveness, lack of contrast exposure, nonionizing radiation and high degree of soft tissue resolution with multiplanar mode of imaging.

Accuracy of Shoulder Ultrasound for Diagnosis of Rotator Cuff Pathologies

“…USG findings showed intact subcapularis tendons in 52 and 49, full tear in 3 and 4, partial tear in 2 and 3 and tendinosis in 17 and 18 cases respectively. Singh et al, [14] evaluated the accuracy of ultrasonography in diagnosing shoulder joint pathologies in 60 patients. USG showed an accuracy of 70%, 95% and 98% in detection of any tear of supraspinatus, subscapularis and infraspinatus tendon respectively using MRI as reference.…”