Shoulder MRI

ESSR SCAN PROTOCOLS

ARTHROGRAM PROTOCOL


ESSR GUIDELINES FOR SHOULDER MRI PLANES


USE OF SHOULDER MRI PLANES

Axial:

  • Acromion.
  • Head of Humerus.
  • Labrum and Cartilage
  • Subscapularis.
  • Infraspinatus/Teres minor.
  • Biceps tendon.

Sagittal:

  • Acromial morphology.
  • Rotator Cuff.
  • Rotator interval.
  • Glenohumeral ligaments
  • Coracoid process
  • Biceps tendons

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Coronal:

  • Acromion and AC joint. 
  • Coracoacromial ligament.
  • Supraspinatus.
  • Glenohumeral joint. 
  • Inferior glenoid recess.
  • Joint effusion.

ABER: (ABduction External Rotation – Sun Bathing posture)

  • Inferior Glenohumeral ligaments.
  • Inferior labrum.

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Courtesy: hitachimed

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Courtesy: www.radiologyassistant.nl

SHOULDER MRI SEQUENCES AND WHAT ARE THESE USED FOR?

SEQUENCES

USES:

 

T1W 
  • Anatomical Details.
  • Marrow signal
  • Fractures
  • AVN
  • Tumours

 

PDW
  • Anatomical details.
  • Cartilage assessment.

 

Fat Suppressed T2 or PD
  • Tendinopathy
  • Tendon tears.
  • Bone Bruising
  • Muscle oedema
  • Effusion. 
  • Cystic lesions
  • Ganglion cyst
  • Muscles cysts
  • Para labral cysts

 

 

Arthrograms
  • Labral tears
  • SLAP tears
  • HAGL lesion.


SHOULDER MRI CHECKLIST

Younger Patients

Trauma, Dislocations, Athletes 

Older Patients

Degenerative disease, Rotator cuff disease
  • Dislocation.
  • AC joint disruption.
  • Hill Sachs lesion.
  • Bankart lesion.
  • SLAP tear

 

  • Fracture Humerus
  • Fracture Acromion
  • Fracture Clavicle
  • HAGL
  • Paralabral Cyst

 

  • Biceps tendon tear
  • NEER type 3 acromion
  • Os-Acromial
  • Acromial Spur
  • AC joint OA
  • Coracoacromial lig. thickening
  • SASD bursitis
  • Rotator cuff tendinopathy
  • Rotator cuff tear
  • Rotator cuff retraction/atrophy
  • Biceps tendon tear

 

 

Other Diagnosis 

Special Diagnosis
  • Tumour
  • GH joint OA
  • Septic arthritis
  • Sub-coracoid Impingement
  • Reverse Bankart and Reverse Hill Sachs
  • Muscle Denervation
  • Quadrilateral space syndrome

 


STANDARD MRI SHOULDER REPORT

FINDINGS:

Unremarkable acromioclavicular joint.

Intact glenohumeral joint with no fracture or dislocation.

There is no labral tear.

The unremarkable long head of biceps tendon.

No focal bony lesion.

Unremarkable periarticular soft tissues.

Intact rotator cuff muscles and tendons.

Preserved muscle bulk and signal.

 

IMPRESSION:

Unremarkable MRI of the shoulder.

You may want to consider Radicon Case Review Series: