Diagnosis of proximal humerus fractures by US has been described [25], but US is not generally considered a preferred imaging modality for assessing osseous pathology, which are of primary concern in initial assessment of traumatic shoulder pain. FDG-PET/CT Skull Base to Mid-Thigh Positron emission tomography (PET) (usually using the fluorine-18-2-fluoro-2-deoxy-D-glucose [FDG] tracer) imaging is rarely used in assessment of traumatic shoulder pain. FDG-PET is sensitive for inflammation, and a correlation has been found between radiotracer activity and degree of shoulder pain [26]. However, increased radiotracer activity may be due to infectious, traumatic, inflammatory, or neoplastic processes, making this activity a nonspecific finding. FDG-PET imaging as an isolated modality has relatively poor resolution for pathology localization compared with other imaging modalities; however, FDG-PET imaging can be performed in conjunction with MRI or CT for better localization of radiotracer activity. FDG-PET in combination with CT (FDG-PET/CT) is sensitive for identifying fractures, and it has been shown to be reliable in differentiating benign from malignant pathologic fractures [27]. FDG-PET/CT imaging is not routinely performed for characterization of soft-tissue injuries of the shoulder. Indirect identification of symptomatic rotator cuff tears has been described on FDG-PET/CT by decreased radiotracer activity in the muscles of the torn tendons and increased activity of surrounding shoulder girdle muscles due to muscle recruitment [28,29]. Other soft-tissue injuries, such as labral and cartilage injuries, have not been described using FDG-PET/CT. Bone Scan Shoulder Tc-99m bone scintigraphy is rarely used in the assessment of traumatic shoulder pain. Bone scintigraphy demonstrates increased activity in many post-traumatic shoulder pathologies, such as fracture, rotator cuff tear, or adhesive capsulitis [30].
Shoulder Pain Traumatic PCAs. Diagnosis of proximal humerus fractures by US has been described [25], but US is not generally considered a preferred imaging modality for assessing osseous pathology, which are of primary concern in initial assessment of traumatic shoulder pain. FDG-PET/CT Skull Base to Mid-Thigh Positron emission tomography (PET) (usually using the fluorine-18-2-fluoro-2-deoxy-D-glucose [FDG] tracer) imaging is rarely used in assessment of traumatic shoulder pain. FDG-PET is sensitive for inflammation, and a correlation has been found between radiotracer activity and degree of shoulder pain [26]. However, increased radiotracer activity may be due to infectious, traumatic, inflammatory, or neoplastic processes, making this activity a nonspecific finding. FDG-PET imaging as an isolated modality has relatively poor resolution for pathology localization compared with other imaging modalities; however, FDG-PET imaging can be performed in conjunction with MRI or CT for better localization of radiotracer activity. FDG-PET in combination with CT (FDG-PET/CT) is sensitive for identifying fractures, and it has been shown to be reliable in differentiating benign from malignant pathologic fractures [27]. FDG-PET/CT imaging is not routinely performed for characterization of soft-tissue injuries of the shoulder. Indirect identification of symptomatic rotator cuff tears has been described on FDG-PET/CT by decreased radiotracer activity in the muscles of the torn tendons and increased activity of surrounding shoulder girdle muscles due to muscle recruitment [28,29]. Other soft-tissue injuries, such as labral and cartilage injuries, have not been described using FDG-PET/CT. Bone Scan Shoulder Tc-99m bone scintigraphy is rarely used in the assessment of traumatic shoulder pain. Bone scintigraphy demonstrates increased activity in many post-traumatic shoulder pathologies, such as fracture, rotator cuff tear, or adhesive capsulitis [30].