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 rotator cuff disorder or subacromial subdeltoid bursitis is suspected. CT Shoulder Without IV Contrast CT shoulder without IV contrast is of limited utility when evaluating for rotator cuff tear or subacromial subdeltoid bursitis. Noncontrast CT can sometimes demonstrate fatty infiltration of rotator cuff muscles with a corresponding rotator cuff tear, although the overall sensitivity of this finding is low [19]. CT may demonstrate a high-riding humeral head or remodeling of the acromial undersurface in patients with large rotator cuff tears. However, this finding is generally seen on initial radiographs, and CT does not allow for characterization of the underlying tear because CT lacks the soft-tissue contrast resolution necessary to adequately evaluate the rotator cuff tear itself. CT may be able to directly demonstrate some large rotator cuff tears as well as fatty infiltration of the rotator cuff musculature; however, it was found to have a sensitivity of 20% for full thickness rotator cuff tears in one small study [19]. Large amounts of fluid in the subacromial subdeltoid bursa can sometimes be visualized with CT. 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 rotator cuff disorder or subacromial subdeltoid bursitis is suspected. Image-Guided Anesthetic +/- Corticosteroid Injection Shoulder or Surrounding Structures Corticosteroid injection is sometimes used before advanced imaging is obtained but may serve as a better diagnostic tool in patients with subacromial subdeltoid bursitis as opposed to those patients with suspected rotator cuff tear.
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 rotator cuff disorder or subacromial subdeltoid bursitis is suspected. CT Shoulder Without IV Contrast CT shoulder without IV contrast is of limited utility when evaluating for rotator cuff tear or subacromial subdeltoid bursitis. Noncontrast CT can sometimes demonstrate fatty infiltration of rotator cuff muscles with a corresponding rotator cuff tear, although the overall sensitivity of this finding is low [19]. CT may demonstrate a high-riding humeral head or remodeling of the acromial undersurface in patients with large rotator cuff tears. However, this finding is generally seen on initial radiographs, and CT does not allow for characterization of the underlying tear because CT lacks the soft-tissue contrast resolution necessary to adequately evaluate the rotator cuff tear itself. CT may be able to directly demonstrate some large rotator cuff tears as well as fatty infiltration of the rotator cuff musculature; however, it was found to have a sensitivity of 20% for full thickness rotator cuff tears in one small study [19]. Large amounts of fluid in the subacromial subdeltoid bursa can sometimes be visualized with CT. 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 rotator cuff disorder or subacromial subdeltoid bursitis is suspected. Image-Guided Anesthetic +/- Corticosteroid Injection Shoulder or Surrounding Structures Corticosteroid injection is sometimes used before advanced imaging is obtained but may serve as a better diagnostic tool in patients with subacromial subdeltoid bursitis as opposed to those patients with suspected rotator cuff tear.