CT can also be used when a fracture is suspected clinically but the radiographs are negative such as in the setting of a suspected acromial stress fracture in the patient with a reverse total shoulder arthroplasty [23]. Fluoride PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of fluoride PET/CT as a first-line imaging modality in the acutely symptomatic patient with a primary shoulder arthroplasty. MRI Shoulder MRI is not typically ordered for the initial evaluation of a symptomatic shoulder arthroplasty but, in the opinion of the committee, can play a contributory role when fractures are occult on radiographs and/or CT examinations. MRI can identify the location of the fracture by detecting associated marrow edema and, not infrequently, an associated fracture line. MRI also well delineates soft-tissue abnormalities in the setting of infection and rotator cuff injury. Radiography Shoulder Radiography is the first and main imaging modality utilized in the evaluation of both the symptomatic and asymptomatic shoulder arthroplasty [10,13]. Findings on radiographs can be used to diagnose and guide further assessment of both osseous and high-grade rotator cuff abnormalities. Radiographs are particularly helpful for the detection of scapular fractures that can occur with relatively minor trauma in patients with reverse shoulder prostheses [24]. US Shoulder US examinations are not typically ordered as a first-line study for evaluation of pain in the setting of shoulder arthroplasty. Nevertheless, US provides assessment of the rotator cuff integrity and is capable of detecting cortical discontinuity and step-off in the setting of a fracture after shoulder arthroplasty [25]. Variant 3: Symptomatic patient with a primary shoulder arthroplasty, infection not excluded. Additional imaging following radiographs.
Imaging After Shoulder Arthroplasty PCAs. CT can also be used when a fracture is suspected clinically but the radiographs are negative such as in the setting of a suspected acromial stress fracture in the patient with a reverse total shoulder arthroplasty [23]. Fluoride PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of fluoride PET/CT as a first-line imaging modality in the acutely symptomatic patient with a primary shoulder arthroplasty. MRI Shoulder MRI is not typically ordered for the initial evaluation of a symptomatic shoulder arthroplasty but, in the opinion of the committee, can play a contributory role when fractures are occult on radiographs and/or CT examinations. MRI can identify the location of the fracture by detecting associated marrow edema and, not infrequently, an associated fracture line. MRI also well delineates soft-tissue abnormalities in the setting of infection and rotator cuff injury. Radiography Shoulder Radiography is the first and main imaging modality utilized in the evaluation of both the symptomatic and asymptomatic shoulder arthroplasty [10,13]. Findings on radiographs can be used to diagnose and guide further assessment of both osseous and high-grade rotator cuff abnormalities. Radiographs are particularly helpful for the detection of scapular fractures that can occur with relatively minor trauma in patients with reverse shoulder prostheses [24]. US Shoulder US examinations are not typically ordered as a first-line study for evaluation of pain in the setting of shoulder arthroplasty. Nevertheless, US provides assessment of the rotator cuff integrity and is capable of detecting cortical discontinuity and step-off in the setting of a fracture after shoulder arthroplasty [25]. Variant 3: Symptomatic patient with a primary shoulder arthroplasty, infection not excluded. Additional imaging following radiographs.