MRI of the shoulder (an approach)

Changed by Yoshi Yu, 20 Mar 2024
Disclosures - updated 23 Oct 2023: Nothing to disclose

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MRI of the shoulder is one of the more frequent examinations faced in daily radiological practice. This approach is an example of how to create a radiological report of an MRI shoulder with coverage of the most common anatomical sites of possible pathology.

Systematic review

A systematic review in the MRI of the shoulder is essential since shoulder anatomy itself is rather complex, and pathologies and injury patterns are manifold and only rarely lead to an abnormality of a single structure but rather show diverse findings which might need to be addressed in further patient management.

Bones

The bony structures of the shoulder, the pictured proximal humerus, the pictured scapula with the glenoid, coracoid process as well as the acromion and the distal clavicle are assessed:

Acromioclavicular joint and coracoacromial arch

Assessment of the acromioclavicular joint, including including acromial shape, downslope, variant anatomy.

Subacromial-subdeltoid bursa
Rotator cuff

Assessment of the following structures:

Precise assessment and description and grading of the rotator cuff pathology (e.g. tendinosis, partial-thickness, full-thickness rotator cuff tear, or calcium deposits) including the shape, extension, and tear dimensions if applicable.

Muscles are assessed with respect to atrophy, fatty degeneration, and oedema as as a result of a rotator cuff tear or in nerve compression syndromes.

Rotator interval and long head biceps tendon

Assessment of the following structures:

The rotator interval is assessed with respect to biceps pulley injury and and in cases of suspected adhesive capsulitis.

Glenohumeral articulation

Assessment of the following structures:

Soft tissues

Assessment of deltoid and and pectoralis muscles and the subcutaneous fat:

Common pathology

  • -<p><strong>MRI of the shoulder</strong> is one of the more frequent examinations faced in daily radiological practice. This approach is an example of how to create a radiological report of an MRI shoulder with coverage of the most common anatomical sites of possible pathology.</p><h4>Systematic review</h4><p>A systematic review in the MRI of the shoulder is essential since shoulder anatomy itself is rather complex, and pathologies and injury patterns are manifold and only rarely lead to an abnormality of a single structure but rather show diverse findings which might need to be addressed in further patient management.</p><h5>Bones</h5><p>The bony structures of the shoulder, the pictured proximal humerus, the pictured scapula with the glenoid, <a href="/articles/coracoid-process">coracoid process</a> as well as the <a href="/articles/acromion">acromion</a> and the distal <a href="/articles/clavicle">clavicle</a> are assessed:</p><ul><li><p><a href="/articles/osteonecrosis-of-the-humeral-head">osteonecrosis of the humeral head</a>, <a href="/articles/bone-tumours">bone tumours</a>, fractures, <a href="/articles/hill-sachs-defect">Hill Sachs defect</a>, <a href="/articles/bankart-lesion">bony Bankart lesion</a></p></li></ul><h5>Acromioclavicular joint and coracoacromial arch </h5><p>Assessment of the <a href="/articles/acromioclavicular-joint-1">acromioclavicular joint</a>, including acromial shape, downslope, variant anatomy.</p><ul><li><p><a href="/articles/acromioclavicular-joint-injury-1">acromioclavicular injury</a>, arthritis, <a href="/articles/acromial-types">hooked acromion</a>, lateral downslope, <a href="/articles/os-acromiale">os acromiale</a>, <a href="/articles/acromial-apophysiolysis">acromial apophysiolysis</a>, <a href="/articles/geyser-sign-shoulder-1">Geyser sign</a></p></li></ul><h5>Subacromial-subdeltoid bursa</h5><ul><li><p><a href="/articles/subacromial-subdeltoid-bursitis">subacromial bursitis</a>, fluid</p></li></ul><h5>Rotator cuff</h5><p>Assessment of the following structures:</p><ul>
  • +<p><strong>MRI of the shoulder</strong> is one of the more frequent examinations faced in daily radiological practice. This approach is an example of how to create a radiological report of an MRI shoulder with coverage of the most common anatomical sites of possible pathology.</p><h4>Systematic review</h4><p>A systematic review in the MRI of the shoulder is essential since shoulder anatomy itself is rather complex, and pathologies and injury patterns are manifold and only rarely lead to an abnormality of a single structure but rather show diverse findings which might need to be addressed in further patient management.</p><h5>Bones</h5><p>The bony structures of the shoulder, the pictured proximal humerus, the pictured scapula with the glenoid, <a href="/articles/coracoid-process">coracoid process</a> as well as the <a href="/articles/acromion">acromion</a> and the distal <a href="/articles/clavicle">clavicle</a> are assessed:</p><ul><li><p><a href="/articles/osteonecrosis-of-the-humeral-head">osteonecrosis of the humeral head</a>, <a href="/articles/bone-tumours-overview">bone tumours</a>, fractures, <a href="/articles/hill-sachs-defect">Hill Sachs defect</a>, <a href="/articles/bankart-lesion">bony Bankart lesion</a></p></li></ul><h5>Acromioclavicular joint and coracoacromial arch&nbsp;</h5><p>Assessment of the <a href="/articles/acromioclavicular-joint-1">acromioclavicular joint</a>,&nbsp;including acromial shape, downslope, variant anatomy.</p><ul><li><p><a href="/articles/acromioclavicular-joint-injury-1">acromioclavicular injury</a>, arthritis, <a href="/articles/acromial-types">hooked acromion</a>, lateral downslope, <a href="/articles/os-acromiale">os acromiale</a>, <a href="/articles/acromial-apophysiolysis">acromial apophysiolysis</a>, <a href="/articles/geyser-sign-shoulder-1">Geyser sign</a></p></li></ul><h5>Subacromial-subdeltoid bursa</h5><ul><li><p><a href="/articles/subacromial-subdeltoid-bursitis">subacromial bursitis</a>, fluid</p></li></ul><h5>Rotator cuff</h5><p>Assessment of the following structures:</p><ul>
  • -</ul><p>Precise assessment and description and grading of the <a href="/articles/rotator-cuff">rotator cuff</a> pathology (e.g. tendinosis, <a href="/articles/partial-thickness-rotator-cuff-tear">partial-thickness</a>, <a href="/articles/full-thickness-rotator-cuff-tear-1">full-thickness rotator cuff tear</a>, or <a href="/articles/hydroxyapatite-deposition-disease">calcium deposits</a>) including the shape, extension, and tear dimensions if applicable.</p><p>Muscles are assessed with respect to <a href="/articles/goutallier-classification-of-rotator-cuff-muscle-fatty-degeneration">atrophy</a>, <a href="/articles/goutallier-classification-of-rotator-cuff-muscle-fatty-degeneration">fatty degeneration</a>, and <a href="/articles/skeletal-muscle-oedema-on-mri-differential">oedema</a> as a result of a rotator cuff tear or in <a href="/articles/nerve-compression-syndrome">nerve compression syndromes</a>.</p><h5>Rotator interval and long head biceps tendon</h5><p>Assessment of the following structures:</p><ul>
  • +</ul><p>Precise assessment and description and grading of the <a href="/articles/rotator-cuff">rotator cuff</a> pathology (e.g. tendinosis, <a href="/articles/partial-thickness-rotator-cuff-tear">partial-thickness</a>, <a href="/articles/full-thickness-rotator-cuff-tear-1">full-thickness rotator cuff tear</a>, or <a href="/articles/hydroxyapatite-deposition-disease">calcium deposits</a>) including the shape, extension, and tear dimensions if applicable.</p><p>Muscles are assessed with respect to <a href="/articles/goutallier-classification-of-rotator-cuff-muscle-fatty-degeneration">atrophy</a>, <a href="/articles/goutallier-classification-of-rotator-cuff-muscle-fatty-degeneration">fatty degeneration</a>, and <a href="/articles/skeletal-muscle-oedema-on-mri-differential">oedema</a>&nbsp;as a result of a rotator cuff tear or in <a href="/articles/nerve-compression-syndrome">nerve compression syndromes</a>.</p><h5>Rotator interval and long head biceps tendon</h5><p>Assessment of the following structures:</p><ul>
  • -</ul><p>The <a href="/articles/rotator-cuff-interval">rotator interval</a> is assessed with respect to <a href="/articles/biceps-pulley-injury">biceps pulley injury</a> and in cases of suspected <a href="/articles/adhesive-capsulitis-of-the-shoulder">adhesive capsulitis</a>.</p><h5>Glenohumeral articulation</h5><p>Assessment of the following structures:</p><ul>
  • +</ul><p>The <a href="/articles/rotator-cuff-interval">rotator interval</a> is assessed with respect to <a href="/articles/biceps-pulley-injury">biceps pulley injury</a>&nbsp;and in cases of suspected <a href="/articles/adhesive-capsulitis-of-the-shoulder">adhesive capsulitis</a>.</p><h5>Glenohumeral articulation</h5><p>Assessment of the following structures:</p><ul>
  • -<p>joint space </p>
  • +<p>joint space&nbsp;</p>
  • -<p><a href="/articles/glenohumeral-ligaments">medial</a> and <a href="/articles/glenohumeral-ligaments">inferior glenohumeral ligaments</a></p>
  • +<p><a href="/articles/glenohumeral-ligaments" title="Glenohumeral ligaments">middle</a> and <a href="/articles/glenohumeral-ligaments">inferior glenohumeral ligaments</a></p>
  • -</ul><h5>Soft tissues</h5><p>Assessment of <a href="/articles/deltoid-muscle">deltoid</a> and <a href="/articles/pectoralis-major-muscle-1">pectoralis muscles</a> and the subcutaneous fat:</p><ul><li><p><a href="/articles/pectoralis-major-injury">pectoralis tear</a>, <a href="/articles/lipoma">lipoma</a></p></li></ul><h4>Common pathology</h4><ul>
  • +</ul><h5>Soft tissues</h5><p>Assessment of <a href="/articles/deltoid-muscle">deltoid</a>&nbsp;and <a href="/articles/pectoralis-major-muscle-1">pectoralis muscles</a> and the subcutaneous fat:</p><ul><li><p><a href="/articles/pectoralis-major-injury">pectoralis tear</a>, <a href="/articles/lipoma">lipoma</a></p></li></ul><h4>Common pathology</h4><ul>

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