CT arthrograms have been shown to be comparable to magnetic resonance (MR) arthrography in diagnosing Bankart, Hill-Sachs, superior labral anterior-to-posterior (SLAP), and full-thickness rotator cuff tears, but inferior to MR arthrography for diagnosing partial-thickness rotator cuff tears [12], including bursal-sided tears. CT arthrography has also only demonstrated modest agreement between observers in diagnosing anterior capsular laxity of the shoulder [13]. MRI Shoulder Noncontrast MR imaging (MRI) has been shown to be effective in assessing bony morphology and bone loss in patients with traumatic shoulder injuries [14-18], and noncontrast MRI is effective in diagnosing most traumatic soft-tissue pathologies including labral, rotator cuff, and glenohumeral ligament injuries [17,19,20]. MR Arthrography Shoulder MR arthrography is considered the gold standard for imaging traumatic shoulder pain [4,17,19,21]. MR arthrography is comparable to noncontrast MRI in assessment of extra-articular soft tissues, and MR arthrography has been shown to be superior to noncontrast MRI in diagnosing intra-articular pathology like SLAP tears, labroligamentous injuries, and partial rotator cuff tears [17,19]. MR arthrography is comparable to CT in evaluating traumatic osseous lesions, such as bony Bankart and Hill-Sachs lesions [12,18]. However, the need for an invasive procedure makes MR arthrography a suboptimal initial study. US Shoulder Ultrasound (US) has limited usefulness in patients with traumatic shoulder pain that cannot be localized to the rotator cuff or biceps tendon. US is comparable to MRI in evaluating full-thickness rotator cuff tears and rotator cuff atrophy [17,22,23]. However, US is inferior to MRI in evaluating partial-thickness rotator cuff tears and other intra-articular pathology [17,24].
Shoulder Pain Traumatic PCAs. CT arthrograms have been shown to be comparable to magnetic resonance (MR) arthrography in diagnosing Bankart, Hill-Sachs, superior labral anterior-to-posterior (SLAP), and full-thickness rotator cuff tears, but inferior to MR arthrography for diagnosing partial-thickness rotator cuff tears [12], including bursal-sided tears. CT arthrography has also only demonstrated modest agreement between observers in diagnosing anterior capsular laxity of the shoulder [13]. MRI Shoulder Noncontrast MR imaging (MRI) has been shown to be effective in assessing bony morphology and bone loss in patients with traumatic shoulder injuries [14-18], and noncontrast MRI is effective in diagnosing most traumatic soft-tissue pathologies including labral, rotator cuff, and glenohumeral ligament injuries [17,19,20]. MR Arthrography Shoulder MR arthrography is considered the gold standard for imaging traumatic shoulder pain [4,17,19,21]. MR arthrography is comparable to noncontrast MRI in assessment of extra-articular soft tissues, and MR arthrography has been shown to be superior to noncontrast MRI in diagnosing intra-articular pathology like SLAP tears, labroligamentous injuries, and partial rotator cuff tears [17,19]. MR arthrography is comparable to CT in evaluating traumatic osseous lesions, such as bony Bankart and Hill-Sachs lesions [12,18]. However, the need for an invasive procedure makes MR arthrography a suboptimal initial study. US Shoulder Ultrasound (US) has limited usefulness in patients with traumatic shoulder pain that cannot be localized to the rotator cuff or biceps tendon. US is comparable to MRI in evaluating full-thickness rotator cuff tears and rotator cuff atrophy [17,22,23]. However, US is inferior to MRI in evaluating partial-thickness rotator cuff tears and other intra-articular pathology [17,24].