From the Guidelines
An MRI is recommended for right shoulder pain that persists despite conservative treatment for 4-6 weeks, or immediately if there's significant trauma, suspected rotator cuff tear, or neurological symptoms. The MRI will provide detailed images of soft tissues including tendons, ligaments, labrum, and cartilage that aren't visible on X-rays 1. Before your MRI, you'll need to remove all metal objects, inform the technician about any implants or claustrophobia concerns, and remain still during the 30-45 minute procedure. The MRI is painless but produces loud noises (earplugs will be provided). No special preparation is needed, though you may be asked to change into a gown.
Key Considerations
- Your doctor will review the results with you, typically within 1-3 days, to determine the cause of your pain and develop an appropriate treatment plan.
- MRIs are particularly valuable for diagnosing rotator cuff tears, labral injuries, bursitis, and other soft tissue abnormalities that commonly cause shoulder pain 1.
- If there is any question concerning the distinction between a full-thickness and partial-thickness tear, MR arthrography (MRA) is recommended, as it is particularly helpful if the abnormal signal intensity extends from the undersurface of the tendon 1.
Additional Information
- MR arthrography is considered the gold standard for imaging traumatic shoulder pain, and is comparable with noncontrast MRI in the assessment of extra-articular soft tissues, and superior to noncontrast MRI in diagnosing intra-articular pathology such as SLAP tears, labroligamentous injuries, and partial rotator cuff tears 1.
From the Research
Right Shoulder Pain MRI
- MRI is an essential auxiliary tool for evaluating shoulder pain due to its high resolution and sensitivity in depicting soft tissues 2.
- The imaging technique, normal imaging anatomy, and common imaging findings of disorders of tendons, labrum, and ligaments of the shoulder can be reviewed using MRI 2.
- For chronic shoulder pain, the recommended radiographic views and best next imaging test after radiographs depend on the clinical diagnosis, with ultrasound preferred over MRI for evaluating chronic rotator cuff pain 3.
- MR arthrography is most accurate for imaging chronic symptoms from a suspected labral tear or instability, preferably with abducted and externally rotated images 3.
- MRI can be used to evaluate the integrity of the repaired tendon after rotator cuff repair, with no significant difference in the rate of retears between patients who received intra-articular corticosteroid injections and those who did not 4.
- A standardized MRI interpretative approach can be used to review common shoulder pathologies, including labral and rotator cuff tears 5.
- Non-contrast MRI can be reliable for diagnosing full thickness rotator cuff tears and anterior labral tears, but may not be sufficient for diagnosing other types of labral tears, such as SLAP tears 6.
- The sensitivity and specificity of MRI in diagnosing full thickness rotator cuff tears were 0.90 and 0.91, respectively, while the sensitivity and specificity of MRI in diagnosing labral tears were 0.52 and 0.89, respectively 6.