How to Order an MRI of the Left Humerus
Order "MRI left shoulder without IV contrast" to image the left humerus between the elbow and shoulder.
Correct Ordering Terminology
The left humerus is imaged as part of a shoulder MRI protocol, not as a separate "humerus MRI." 1
- Standard order: "MRI left shoulder without IV contrast" 1
- This protocol automatically includes the proximal and mid-humeral shaft in the field of view 2
- The shoulder MRI protocol extends from the acromioclavicular joint superiorly to the mid-humeral shaft inferiorly 2
Why "Without IV Contrast" is Preferred
MRI without IV contrast is the appropriate initial study for most humeral pathology. 1
- Noncontrast MRI effectively demonstrates bone marrow edema, fractures, soft tissue injuries, and rotator cuff pathology 1
- IV contrast adds no diagnostic value for traumatic injuries, fractures, or bone marrow abnormalities 1
- In acute trauma settings, joint effusion provides natural contrast for soft tissue visualization 1
Standard MRI Shoulder Protocol Includes
The routine shoulder MRI protocol captures the entire proximal humerus and includes: 2
- Coronal sequences: Best for evaluating humeral cortex, bone marrow, and rotator cuff attachments 2, 3
- Axial sequences: Optimal for assessing humeral head, bicipital groove, and cross-sectional anatomy 2
- Sagittal sequences: Useful for anteroposterior relationships and glenohumeral joint 2
Common Pitfalls to Avoid
Do not order "MRI humerus" as this is not a standard imaging protocol. 1
- Radiology departments use anatomic region protocols (shoulder, elbow), not individual bone protocols 1
- If you need to image the distal humerus near the elbow, order "MRI left elbow without IV contrast" instead 1
- For mid-shaft humerus pathology, specify in the clinical indication that mid-humeral shaft evaluation is needed 2
When to Consider Alternative Imaging
CT without IV contrast is superior to MRI for complex fracture characterization. 1
- Order "CT left shoulder without IV contrast" if you suspect comminuted proximal humerus fracture 1
- CT provides better spatial resolution for fracture planes and surgical planning 1, 4, 5
- CT is preferred when MRI is contraindicated or when evaluating hardware-related complications 1
Clinical Indication Matters
Include specific clinical information on the order to optimize the imaging protocol: 1, 2