CT arthrography can be considered a reasonable imaging alternative in patients with contraindication to MRI. US Shoulder US Shoulder There is no role for US in assessment of Bankart or Hill-Sachs lesions. US has been demonstrated to be inferior to MRI in diagnosing both labroligamentous injury and Hill-Sachs lesions [17]. FDG-PET/CT Skull Base to Mid-Thigh There is no role for FDG-PET/CT in assessment of Bankart or Hill-Sachs lesions. Bone Scan Shoulder Bone Scan Shoulder There is no role for bone scintigraphy in assessment of Bankart or Hill-Sachs lesions. Variant 6: Traumatic shoulder pain. Radiographs normal. Physical examination and history consistent with dislocation event or instability. Next imaging study. Shoulder dislocation or instability is most common in the anterior direction. Younger patients are more likely to have labroligamentous injury and persistent instability after dislocation compared with older patients [54]. Older patients are more likely to have rotator cuff tears in association with shoulder dislocation [55]. Coexisting humeral avulsion of the glenohumeral ligament and significant glenoid bone loss have been found in up to 10% of patients with recurrent shoulder instability [56], which underscores the need to assess both osseous and labroligamentous pathology in patients with shoulder dislocation or instability. Glenoid morphology and bone loss can play a significant factor in recurrent shoulder dislocations [15,16,57], which may require bone grafting in order to restore stability [57]. MR Arthrography Shoulder MR arthrography is the preferred examination for the evaluation of subacute shoulder dislocations or recurrent shoulder instability. MRI has been shown to have similar performance to CT in the evaluation of Hill-Sachs lesions and glenoid bone loss [12,18]. MR arthrography has also been found to be reliable in diagnosing anterior shoulder instability and labroligamentous injuries [58,59].
Shoulder Pain Traumatic PCAs. CT arthrography can be considered a reasonable imaging alternative in patients with contraindication to MRI. US Shoulder US Shoulder There is no role for US in assessment of Bankart or Hill-Sachs lesions. US has been demonstrated to be inferior to MRI in diagnosing both labroligamentous injury and Hill-Sachs lesions [17]. FDG-PET/CT Skull Base to Mid-Thigh There is no role for FDG-PET/CT in assessment of Bankart or Hill-Sachs lesions. Bone Scan Shoulder Bone Scan Shoulder There is no role for bone scintigraphy in assessment of Bankart or Hill-Sachs lesions. Variant 6: Traumatic shoulder pain. Radiographs normal. Physical examination and history consistent with dislocation event or instability. Next imaging study. Shoulder dislocation or instability is most common in the anterior direction. Younger patients are more likely to have labroligamentous injury and persistent instability after dislocation compared with older patients [54]. Older patients are more likely to have rotator cuff tears in association with shoulder dislocation [55]. Coexisting humeral avulsion of the glenohumeral ligament and significant glenoid bone loss have been found in up to 10% of patients with recurrent shoulder instability [56], which underscores the need to assess both osseous and labroligamentous pathology in patients with shoulder dislocation or instability. Glenoid morphology and bone loss can play a significant factor in recurrent shoulder dislocations [15,16,57], which may require bone grafting in order to restore stability [57]. MR Arthrography Shoulder MR arthrography is the preferred examination for the evaluation of subacute shoulder dislocations or recurrent shoulder instability. MRI has been shown to have similar performance to CT in the evaluation of Hill-Sachs lesions and glenoid bone loss [12,18]. MR arthrography has also been found to be reliable in diagnosing anterior shoulder instability and labroligamentous injuries [58,59].