Image-Guided Anesthetic +/- Corticosteroid Injection Shoulder or Surrounding Structures Intra-articular corticosteroid injection using either fluoroscopy or US guidance is often used in the conservative management of glenohumeral arthritis [122] and may be performed in some situations before advanced imaging is obtained. The diagnostic utility of glenohumeral corticosteroid injection for confirming osteoarthritis as a source of pain is limited, because patients with osteoarthritis have a similar degree of pain improvement (74% rate of clinically relevant improvement at 1 month) as patients with other underlying causes of shoulder pain [23]. MR Arthrography Shoulder The role of MR arthrography relative to conventional shoulder MRI in the setting of osteoarthritis has not been specifically studied. However, MR arthrography may have use in characterizing the degree of chondral loss, the presence of a full thickness rotator cuff tear, and characterizing glenoid morphology. MRI Shoulder Without and With IV Contrast There is insufficient evidence to support the use of MRI shoulder without and with IV contrast in the evaluation of chronic shoulder pain when initial radiographs demonstrate osteoarthritis. MRI Shoulder Without IV Contrast MRI can be used to detect the degree of glenohumeral chondral loss, although the diagnosis of arthritis is generally easily made with conventional radiographs [142]. MRI can demonstrate the presence of a partial or full thickness rotator cuff tear, which is frequently associated with osteoarthritis. Although CT is most frequently used for evaluating glenoid morphology, glenoid version measured by MRI is generally similar to that measured with CT [143]; however, MRI may be less accurate than CT at identifying the Walch classification of glenoid morphology [144]. Chronic Shoulder Pain Radiography Shoulder Additional Views Glenohumeral osteoarthritis is typically well visualized on conventional radiographic views, without the need for special views.
Chronic Shoulder Pain PCAs. Image-Guided Anesthetic +/- Corticosteroid Injection Shoulder or Surrounding Structures Intra-articular corticosteroid injection using either fluoroscopy or US guidance is often used in the conservative management of glenohumeral arthritis [122] and may be performed in some situations before advanced imaging is obtained. The diagnostic utility of glenohumeral corticosteroid injection for confirming osteoarthritis as a source of pain is limited, because patients with osteoarthritis have a similar degree of pain improvement (74% rate of clinically relevant improvement at 1 month) as patients with other underlying causes of shoulder pain [23]. MR Arthrography Shoulder The role of MR arthrography relative to conventional shoulder MRI in the setting of osteoarthritis has not been specifically studied. However, MR arthrography may have use in characterizing the degree of chondral loss, the presence of a full thickness rotator cuff tear, and characterizing glenoid morphology. MRI Shoulder Without and With IV Contrast There is insufficient evidence to support the use of MRI shoulder without and with IV contrast in the evaluation of chronic shoulder pain when initial radiographs demonstrate osteoarthritis. MRI Shoulder Without IV Contrast MRI can be used to detect the degree of glenohumeral chondral loss, although the diagnosis of arthritis is generally easily made with conventional radiographs [142]. MRI can demonstrate the presence of a partial or full thickness rotator cuff tear, which is frequently associated with osteoarthritis. Although CT is most frequently used for evaluating glenoid morphology, glenoid version measured by MRI is generally similar to that measured with CT [143]; however, MRI may be less accurate than CT at identifying the Walch classification of glenoid morphology [144]. Chronic Shoulder Pain Radiography Shoulder Additional Views Glenohumeral osteoarthritis is typically well visualized on conventional radiographic views, without the need for special views.