From the Guidelines
A rotator cuff injury is unlikely to be visible on a Computed Tomography (CT) scan.
Evidence Summary
- The American College of Radiology states that CT has virtually no usefulness in diagnosing common traumatic soft-tissue injuries such as rotator cuff tears 1.
- A study from the Journal of the American College of Radiology rated CT shoulder without contrast as a 1, indicating it is usually not appropriate for evaluating rotator cuff injuries 1.
- While CT arthrography may be comparable to MR arthrography in diagnosing full-thickness rotator cuff tears, it has poorer performance for partial-thickness cuff tears 1.
- MRI is generally the preferred imaging modality for evaluating rotator cuff injuries, as it can provide detailed images of soft tissue structures 1.
- CT arthrography may be considered in patients with suspected intra-articular soft-tissue injury and contraindication to MRI, but it is not the first-line imaging choice for rotator cuff injuries 1.
Key Points
- CT scans are not effective for diagnosing rotator cuff tears
- MRI is the preferred imaging modality for evaluating rotator cuff injuries
- CT arthrography may be used in certain cases, but it has limitations in diagnosing partial-thickness rotator cuff tears
From the Research
Visibility of Rotator Cuff Injuries on CT Scans
- A rotator cuff injury may not be visible on a standard Computed Tomography (CT) scan, as CT scans are limited in their ability to provide detailed information on soft tissues 2.
- However, CT arthrography, which involves the introduction of contrast material into the joint cavity, can provide more detailed information on rotator cuff tears 3.
- Studies have shown that CT arthrography can be an effective method for assessing the extent and portion of rotator cuff tears, with a high degree of accuracy 3, 4.
- The sensitivity and specificity of CT arthrography in depicting rotator cuff lesions have been found to be comparable to those of magnetic resonance (MR) arthrography 4.
- The use of multidetector CT arthrography has been shown to be effective in evaluating rotator cuff lesions, with high sensitivity and specificity rates 4.
Comparison with Other Imaging Modalities
- Magnetic Resonance Imaging (MRI) is generally considered to be a more accurate imaging modality for evaluating the rotator cuff and biceps tendon, as it allows for visualization of the soft tissues and adjacent bony structures 2, 5.
- Ultrasound is also a useful imaging modality for assessing the rotator cuff and biceps tendon, particularly in the initial evaluation of patients with shoulder pain 5, 6.
- The choice of imaging modality depends on the specific clinical question and the availability of resources 6.