CT Shoulder Without and With IV Contrast There is insufficient evidence to support the use of CT shoulder without and with IV contrast in the evaluation of chronic shoulder pain when labral pathology or shoulder instability is suspected. CT Shoulder Without IV Contrast CT is helpful for assessing bony glenoid deficiency as well as the size of a Hill-Sachs deformity when surgery is a consideration but is not effective at evaluating the labrum. CT is often preferable to MRI when evaluating for small fracture fragments of the glenoid rim and assessing bone stock in patients with recurrent dislocation [77-79]. Three- dimensional reconstructions can be used to quantify osseous defect width and glenoid surface area [80,81]. CT can also be used to measure the size of a Hill-Sachs defect [82,83], which has become more important with the development of the glenoid track concept for determining instability [84,85]. In the postoperative setting, CT can be used to evaluate integration of bone graft from a coracoid transfer with the underlying glenoid [86,87]. FDG-PET/CT Skull Base to Mid-Thigh There is insufficient evidence to support the use of FDG-PET/CT skull base to mid-thigh in the evaluation of chronic shoulder pain when labral pathology or shoulder instability is suspected. Image-Guided Anesthetic +/- Corticosteroid Injection Shoulder or Surrounding Structures Patients with labral tears have been found to have no significant decrease in pain with glenohumeral injection relative to other patients, and, in fact, patients with labral tears may have less pain relief than those with an intact labrum [23]. Thus, corticosteroid injection does not have a significant diagnostic benefit in distinguishing patients with labral tears from other pathology. Chronic Shoulder Pain accuracy for a labral tear as those performed with dilute gadolinium [30,31].
Chronic Shoulder Pain PCAs. CT Shoulder Without and With IV Contrast There is insufficient evidence to support the use of CT shoulder without and with IV contrast in the evaluation of chronic shoulder pain when labral pathology or shoulder instability is suspected. CT Shoulder Without IV Contrast CT is helpful for assessing bony glenoid deficiency as well as the size of a Hill-Sachs deformity when surgery is a consideration but is not effective at evaluating the labrum. CT is often preferable to MRI when evaluating for small fracture fragments of the glenoid rim and assessing bone stock in patients with recurrent dislocation [77-79]. Three- dimensional reconstructions can be used to quantify osseous defect width and glenoid surface area [80,81]. CT can also be used to measure the size of a Hill-Sachs defect [82,83], which has become more important with the development of the glenoid track concept for determining instability [84,85]. In the postoperative setting, CT can be used to evaluate integration of bone graft from a coracoid transfer with the underlying glenoid [86,87]. FDG-PET/CT Skull Base to Mid-Thigh There is insufficient evidence to support the use of FDG-PET/CT skull base to mid-thigh in the evaluation of chronic shoulder pain when labral pathology or shoulder instability is suspected. Image-Guided Anesthetic +/- Corticosteroid Injection Shoulder or Surrounding Structures Patients with labral tears have been found to have no significant decrease in pain with glenohumeral injection relative to other patients, and, in fact, patients with labral tears may have less pain relief than those with an intact labrum [23]. Thus, corticosteroid injection does not have a significant diagnostic benefit in distinguishing patients with labral tears from other pathology. Chronic Shoulder Pain accuracy for a labral tear as those performed with dilute gadolinium [30,31].