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.