Indirect MR arthrography has been shown to have a slightly higher specificity for diagnosing articular- surface partial thickness tears of the supraspinatus and infraspinatus tendons, as well as a greater specificity for diagnosing subscapularis tendon tears [35], relative to noncontrast MRI, and has shown high accuracy relative to arthroscopy [36]. Although the accuracy of indirect MR arthrography has been described in the literature, it is not commonly used in clinical practice. MRI Shoulder Without IV Contrast MRI of the shoulder is a highly accurate tool in the assessment of the rotator cuff. MRI findings of tendinopathy consist of intermediate increased signal and tendon thickening [28]. Rotator cuff tears, particularly full thickness tears, can be reliably identified using conventional MRI with high sensitivity and specificity [37-39]. Sensitivity and specificity for detecting partial thickness bursal surface tears is similar for conventional MRI and MR arthrography [27]. Although MR arthrography may have a slightly higher sensitivity and specificity than conventional MRI for diagnosing rotator cuff tears, particularly partial thickness articular surface tears, this difference in accuracy must be weighed against the need for an invasive arthrogram procedure [29]. Tendon retraction, muscle atrophy, and fatty infiltration are associated important findings that are well seen on MRI and predict reparability of rotator cuff tear [40]. Axial images can be helpful in determining rotator cuff tear shape [41], which can aid in the selection of a particular surgical technique. In addition to evaluating the rotator cuff itself, MRI can detect extra-articular abnormalities that may predispose to shoulder impingement such as acromioclavicular degenerative change or a subacromial spur. Fluid accumulation within the subacromial subdeltoid bursa is visualized on MRI and is often a nonspecific finding seen with a rotator cuff tear or an underlying inflammatory disorder [42].
Chronic Shoulder Pain PCAs. Indirect MR arthrography has been shown to have a slightly higher specificity for diagnosing articular- surface partial thickness tears of the supraspinatus and infraspinatus tendons, as well as a greater specificity for diagnosing subscapularis tendon tears [35], relative to noncontrast MRI, and has shown high accuracy relative to arthroscopy [36]. Although the accuracy of indirect MR arthrography has been described in the literature, it is not commonly used in clinical practice. MRI Shoulder Without IV Contrast MRI of the shoulder is a highly accurate tool in the assessment of the rotator cuff. MRI findings of tendinopathy consist of intermediate increased signal and tendon thickening [28]. Rotator cuff tears, particularly full thickness tears, can be reliably identified using conventional MRI with high sensitivity and specificity [37-39]. Sensitivity and specificity for detecting partial thickness bursal surface tears is similar for conventional MRI and MR arthrography [27]. Although MR arthrography may have a slightly higher sensitivity and specificity than conventional MRI for diagnosing rotator cuff tears, particularly partial thickness articular surface tears, this difference in accuracy must be weighed against the need for an invasive arthrogram procedure [29]. Tendon retraction, muscle atrophy, and fatty infiltration are associated important findings that are well seen on MRI and predict reparability of rotator cuff tear [40]. Axial images can be helpful in determining rotator cuff tear shape [41], which can aid in the selection of a particular surgical technique. In addition to evaluating the rotator cuff itself, MRI can detect extra-articular abnormalities that may predispose to shoulder impingement such as acromioclavicular degenerative change or a subacromial spur. Fluid accumulation within the subacromial subdeltoid bursa is visualized on MRI and is often a nonspecific finding seen with a rotator cuff tear or an underlying inflammatory disorder [42].