MR Imaging Of The Shoulder Pain

It is considered that maladies of the shoulder follow only headaches and back pain as the third most common general physical complaint. The possible reason includes impingment sydrome, biceps pathology, instability and so on. Imaging has a significant role in the diagnosis and treatment of shoulder abnormalities. As a noninvasive technique, MR imaging has the advantages of inherent improved soft-tissue contrast, multipalanar imaging capability and excellent resolution. Conventional MR imaging allows direct visalization of the most of the important anatomic structure of the shoulder. With the publishment of the first article on the use of MR imaging in the assessment of the rotator cuff in 1986, MRI has frequently replaced other techniques for screening of shoulder in recent years.1.PURPOSE:To determine the diagnostic performance of magnetic resonance imaging in the evaluation of the shoulder abnormalities.2.MATERIAL AND METHODS:Twenty-eight patients (18 men, 10 women) with chief complaint of shoulder painunderwent MR imaging of the shoulder. Twenty-eight shoulders were imaged in total.All MR imaging was performed on a 0.5-T MR imaged. SE sequences, FSE sequences and STIR were obtained in axial, coronal oblique and sagital oblique planes for all patients.The images were reviewed for the signal characteristics and morphology of the rotator cuff, bicipital tendon and so on. Then we demonstrated the possibility pathology of the shoulder.3. RESULT:MR findings included: full-thickness and partial-thickness tears of the rotator cuff, tendinitis, calcification of the rotator cuff , biceps tendinitis, biceps dislocation and acromioclavicular joint arthritis. One patient had no positive findings with MR imaging.Six patients received arthroscopy and/or open procedure. Case 1: MR result is supraspinatus tendinitis but the operative result is partial-thickness tears of supraspinatus tendon. Case 2: MR result is full-thickness tears of supraspinatus tendon and infraspinatus tendon , the operative result is the same. Case 3: MR result is calcification and partial-thickness tears of supraspinatus tendon , the operative result is the same. Case 4: MR result is supraspinatus tendinitis but the operative result is partial-thickness tears of supraspinatus tendon. Case 5: MR result is calcification and partial-thickness tears of supraspinatus tendon , the operative result is the same. Case 6: MR result is partial-thickness tears of supraspinatus tendon,full-thickness tears of subscapularis tendon and biceps dislocation , the operative result is the same.The other twenty-two patients received conservative treatment.4. CONCLUSION:We conclude that MRI is a good noninvasive method for the diagnosis of full-thickness tears of rotator cuff. But the distinction between partial-thickness tears and tendinitis remains difficult. The diagnostic value of MR imaging in patients with biceps tendinitis needs more investigation.