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The Journal of Bone and Joint Surgery, Vol 73, Issue 5 707-716, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Evaluation of the painful shoulder. A prospective comparison of magnetic resonance imaging, computerized tomographic arthrography, ultrasonography, and operative findings
MC Nelson, GP Leather, RP Nirschl, FA Pettrone and MT Freedman
Department of Radiology, Georgetown University Medical Center, Washington, D.C. 20007-2197.
Twenty-one patients who had had pain in the shoulder for more than three
months were evaluated with ultrasonography and magnetic resonance imaging
followed by computerized tomographic arthrography. The results of the
imaging studies were then compared with the operative findings. Magnetic
resonance imaging was found to be the most useful modality for
establishment of the etiology of pain in the shoulder due to disease of the
rotator cuff, instability associated with abnormality of the glenoid
labrum, subacromial impingement, stenosis of the coracoacromial arch, and
osteoarthrosis of either the glenohumeral or the acromioclavicular joint.
The accuracy of magnetic resonance imaging was found to depend on both the
operator and the technique and was decreased in extremely obese patients,
due to difficulties in positioning, and in patients who had had a previous
operation. Magnetic resonance imaging was more accurate than either
computerized tomographic arthrography or ultrasonography in identifying
partial-thickness tears (intrasubstance changes in the rotator cuff).
Magnetic resonance imaging provided the same level of accuracy as
computerized tomographic arthrography in the detection of abnormalities of
the glenoid labrum.
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