Variant 8: Traumatic shoulder pain. Radiographs normal. Physical examination findings consistent with rotator cuff tear. Next imaging study. US, MRI, and MR arthrography have similarly high sensitivity and specificity in detection of full-thickness rotator cuff tears. US and MRI have somewhat lower sensitivity for detection of partial-thickness tears when compared to MR arthrography [68]. However, because full-thickness tears are the main decision point on pursuing surgical repair, institutional preference may be the driving force for the selection of imaging modality for assessment of traumatic rotator cuff pathology. MRI Shoulder MRI Shoulder MRI is generally considered the best modality for adequately assessing most soft-tissue injuries, including labroligamentous, cartilage, and rotator cuff pathology [12,17,69]. It has high sensitivity and specificity in detection of full-thickness rotator cuff tears, but lower sensitivity compared to MR arthrography for detection of partial-thickness tears [68]. MR Arthrography Shoulder MR arthrography is generally preferred to noncontrast MRI for assessing intra-articular pathology, particularly in diagnosing labral and partial-thickness rotator cuff tears [17,19,54]. MR arthrography may have increased sensitivity for detection of partial-thickness articular surface supraspinatus tears compared with conventional MRI [19]. CT Arthrography Shoulder CT Arthrography Shoulder CT arthrography has similar performance as MR arthrography for detection of full-thickness rotator cuff tears, but has significantly poorer performance for partial-thickness cuff tears [12]. CT arthrogram may be a good imaging alternative in patients with suspected intra-articular soft-tissue injury and contraindication to MRI. US Shoulder In the post-traumatic setting, US has been shown to detect abnormalities, including rotator cuff tears [25]. In general, US can have high sensitivity and specificity for the detection of full-thickness rotator cuff tears [70-72].
Shoulder Pain Traumatic PCAs. Variant 8: Traumatic shoulder pain. Radiographs normal. Physical examination findings consistent with rotator cuff tear. Next imaging study. US, MRI, and MR arthrography have similarly high sensitivity and specificity in detection of full-thickness rotator cuff tears. US and MRI have somewhat lower sensitivity for detection of partial-thickness tears when compared to MR arthrography [68]. However, because full-thickness tears are the main decision point on pursuing surgical repair, institutional preference may be the driving force for the selection of imaging modality for assessment of traumatic rotator cuff pathology. MRI Shoulder MRI Shoulder MRI is generally considered the best modality for adequately assessing most soft-tissue injuries, including labroligamentous, cartilage, and rotator cuff pathology [12,17,69]. It has high sensitivity and specificity in detection of full-thickness rotator cuff tears, but lower sensitivity compared to MR arthrography for detection of partial-thickness tears [68]. MR Arthrography Shoulder MR arthrography is generally preferred to noncontrast MRI for assessing intra-articular pathology, particularly in diagnosing labral and partial-thickness rotator cuff tears [17,19,54]. MR arthrography may have increased sensitivity for detection of partial-thickness articular surface supraspinatus tears compared with conventional MRI [19]. CT Arthrography Shoulder CT Arthrography Shoulder CT arthrography has similar performance as MR arthrography for detection of full-thickness rotator cuff tears, but has significantly poorer performance for partial-thickness cuff tears [12]. CT arthrogram may be a good imaging alternative in patients with suspected intra-articular soft-tissue injury and contraindication to MRI. US Shoulder In the post-traumatic setting, US has been shown to detect abnormalities, including rotator cuff tears [25]. In general, US can have high sensitivity and specificity for the detection of full-thickness rotator cuff tears [70-72].