FDG-PET/CT Skull Base to Mid-Thigh There is no role for FDG-PET/CT in assessment of vascular compromise. 3-phase Bone Scan Shoulder Three-phase bone scintigraphy can demonstrate a lack of blood flow to an extremity, with blood pool and delayed images showing decreased or absent uptake in the affected area [78]. However, limited resolution precludes precise anatomic definition of the site of abnormality [78]. In addition, because of the length of time required for image acquisition, scintigraphy is not the modality of choice for assessing acute vascular compromise. CT Shoulder CT without contrast may be obtained in the setting of trauma for detection or delineation of fracture and can suggest neural injury based on expected course of the nerves. However, CT is not the modality of choice for assessment of the nerves. CT with contrast may be obtained in the setting of trauma for detection or delineation of arterial injury, and may suggest neural injury based on the expected course of the nerves. However, CT is not the modality of choice for assessment of the nerves. There is no role for biphasic CT in the setting of suspected traumatic nerve injury. CT Arthrography Shoulder There is no role for CT arthrography in the setting of suspected traumatic nerve injury. MRI Shoulder Noncontrast MRI may demonstrate discontinuity of nerves, neuromas, or perineural musculofascial edema; however, the imaging planes and resolution of routine noncontrast MRI is not adequate for confident and complete assessment of the nerves that can be injured at the shoulder [81]. There are no systematic studies on MR neurography in assessment of the peripheral nerves about the shoulder in the post-traumatic setting; however, MR neurography is gaining acceptance in assessment of peripheral nerve injuries [82]. Use of 3T imaging allows for high resolution and excellent soft-tissue contrast and can delineate focal nerve discontinuities, neuromas, and musculofascial edema [83].
Shoulder Pain Traumatic PCAs. FDG-PET/CT Skull Base to Mid-Thigh There is no role for FDG-PET/CT in assessment of vascular compromise. 3-phase Bone Scan Shoulder Three-phase bone scintigraphy can demonstrate a lack of blood flow to an extremity, with blood pool and delayed images showing decreased or absent uptake in the affected area [78]. However, limited resolution precludes precise anatomic definition of the site of abnormality [78]. In addition, because of the length of time required for image acquisition, scintigraphy is not the modality of choice for assessing acute vascular compromise. CT Shoulder CT without contrast may be obtained in the setting of trauma for detection or delineation of fracture and can suggest neural injury based on expected course of the nerves. However, CT is not the modality of choice for assessment of the nerves. CT with contrast may be obtained in the setting of trauma for detection or delineation of arterial injury, and may suggest neural injury based on the expected course of the nerves. However, CT is not the modality of choice for assessment of the nerves. There is no role for biphasic CT in the setting of suspected traumatic nerve injury. CT Arthrography Shoulder There is no role for CT arthrography in the setting of suspected traumatic nerve injury. MRI Shoulder Noncontrast MRI may demonstrate discontinuity of nerves, neuromas, or perineural musculofascial edema; however, the imaging planes and resolution of routine noncontrast MRI is not adequate for confident and complete assessment of the nerves that can be injured at the shoulder [81]. There are no systematic studies on MR neurography in assessment of the peripheral nerves about the shoulder in the post-traumatic setting; however, MR neurography is gaining acceptance in assessment of peripheral nerve injuries [82]. Use of 3T imaging allows for high resolution and excellent soft-tissue contrast and can delineate focal nerve discontinuities, neuromas, and musculofascial edema [83].