The spectrum of MRI findings in painful shoulder: A prospective study of 81 cases

Abstract

Background: Shoulder MRI is now considered the standard among the imaging methods to diagnose the etiology of shoulder pain as MRI allows the direct visualization of the rotator cuff tendons, their tears and abnormalities, their relationship to the undersurface of the acromion and the acromioclavicular (AC) joint and also identifiestears of labro-ligamentous complex. Objective: The purpose of this study was to highlight the MRI spectrum of various non-infective, non-neoplastic pathologies of shoulder joint in patients presenting with pain and to analyse the results statistically.Materials & Methods: This prospective cross-sectional study was conducted on 81 patients in the age group of 16 to 72 years with the complaints of shoulder pain with or without associated instability and restricted mobility using conventional 1.5 T MRI. Informed consent was taken from all the participants.Results: In our study, Rotator cuff tear was the most common lesion noted in 85% cases, out of which the predominant lesion was full-thickness supraspinatus tear, in 29.6% cases. Rotator cuff tendinosis & Impingement syndrome were the second & third most common lesions encountered on MRI in painful shoulder, observed in 77.7% & 39% of the patients respectively. 49% cases showed lesions of both rotator cuff & rotator interval, However only 3% had isolated involvement of rotator interval. 42% had MRI diagnosis of labro-ligamentous tears with bankart lesion & its variants accounted maximum (25%) and its co-occurrence with hill-sachs defect noted in 81% cases.Conclusion: This study concludes that MRI is well accepted, non-invasive imaging modality and can evaluate the patients with shoulder pain efficiently due to its excellent soft tissue contrast and multiplanar acquisition. It also suggests that besides rotator cuff tears, the infrequent but important shoulder pathologies like tears of rotator interval and labro-ligamentous complex can also be detected on conventional MRI with thorough observation.