The lack of support in a shoulder leads to extreme mobility, so it should come as little surprise that shoulder injuries and conditions are very common.
Joints are complex structures that are made up of bone, muscles, synovium, cartilage, and ligaments. When these structures are injured, it can be painful, difficult or impossible to raise the arm up.
Standard X-rays don't show soft tissues, like ligaments and tendons, whereas MRIs do. This is why MRI scans are very helpful with detecting problems in the shoulder area. An MRI scan of the shoulder can help a doctor discover what the issue is and, consequently, assist them to make a diagnosis and to determine the best treatment plan.
An MRI is magnetic resonance imaging that shows images of a shoulder's structure — this includes bones, cartilage, tendons, ligaments, muscles, blood vessels and internal body structures. It's a non-invasive imaging tool that produces many detailed images from multiple angles.
These images are cross-sectional images, which means the images produced are sliced through the middle of the structure. Because a number of images are taken in quick succession, a computer program can be used to stack the images up and make them appear three-dimensional through the use of 3D rendering. This preciseness can help a doctor detect small conditions that may otherwise be missed.
Sometimes, a physician will require a patient to have a contrast MRI scan of the shoulder. This means that a contrast agent (like a dye) will be administered intravenously or the patient will be asked to take it as a barium meal. A contrast agent can improve the clarity of the body's internal structures, helping a radiologist to make a diagnosis.
Unlike X-rays, an MRI doesn't use radiation. Instead, it harnesses radio waves from data that already exist in the body, meaning it won't cause chemical change or damage to tissue.
The shoulder is, quite literally, made out of many moving parts. Because of this, there are a number of conditions that can occur or arise within the area. If a doctor suspects an issue with a ligament, muscle or tendon within the area, they should order an MRI.
Often, a standard X-ray will be ordered first, to see if the problem can be detected. If not, an MRI can show more detail and may be able to identify the issue.
If you are experiencing any of the following issues, you may require a shoulder MRI: unexplained swelling or pain in the shoulder; lack of mobility in the shoulder; pain when arms are lifted; shoulder injuries from an accident or fall; persistent pain that doesn't improve over time; a popping sound in the shoulder when arms are raised or moved; if an abnormality is noticed on an X-ray; or if an X-ray can't detect the reason for shoulder discomfort or pain.
Below are a number of conditions that a shoulder MRI can help diagnose: dislocation of the shoulder joint; rotator cuff tears or injuries; arthritis in the shoulder; infections; tissue damage; torn ligaments or tendons; bone tumours; inflammation in the shoulder; degenerative joint disease; sprains; and bone fractures or breaks.
In order to receive a shoulder MRI, you'll need a referral from a doctor. Before ordering an MRI scan, a doctor will listen to your symptoms and conduct a physical exam. From here, they will often refer you for a standard X-ray. However, if the doctor suspects your condition won't be detected on a standard X-ray, they may skip this step and send you for an MRI straight away.
Some doctors will conduct a contrast scan, and this may require you to fast for a given amount of time. It's best to check with your referring physician about whether you're able to eat or drink before your appointment.
Prior to attending your scan, you should remove all metal objects, like earrings, piercings and hairpins. Metal objects can obstruct the scan which can cause issues when the technician is reading the images. If you have any internal metal implants that can't be removed, like a pacemaker or hearing aid, let your radiologist know prior to the scan.
At your appointment, you will be given a hospital gown to change into. If you are having a contrast scan the doctor will administer the agent through an IV or ask you to consume it as a barium meal.
The technician will fit you with earplugs or headphones to drown out some of the noise the MRI scanner makes. They will also give you a buzzer which, when pressed, will let you speak to the technician during the scan.
After this, the technician will ask you to lie on a narrow metal table and will adjust your body so that the scanner can take clear pictures of your shoulder. The table will slowly slide you inside the MRI scanner. The machine is a small metal tube and is narrow, so if you experience claustrophobia you should let your doctor know prior to the scan. If they see fit, they may offer you a sedative to help calm you.
Once inside, you must ensure that you hold completely still — any movement can blur the images. While the scan is happening, a patient shouldn't feel anything major. Sometimes patients feel a little warm; while this isn't usually something to worry about, it's always a good idea to tell your physician if you do experience this.
After the scan, patients should feel normal. The exception is if a sedative was administered for claustrophobia-related reasons, in which case a patient will require a recovery period and will need someone to drive them home. Sometimes a patient will notice slight nausea or local pain. In rare cases, a patient may have an allergic reaction — if you notice anything like a rash, let a doctor know immediately.
Shoulder MRIs can identify issues with soft tissues within the shoulder which traditional X-rays can't. The preciseness of an MRI means they are able to pick up very small abnormalities that may not otherwise be evident. MRIs are non-invasive and don't involve any radiation, meaning they are a very safe procedure. The results are quick, which means that treatment can be started promptly.
A shoulder MRI will normally take between 30–60 minutes, but in some cases it can take up to two hours. This time includes the preparation — a patient will generally only spend a few minutes inside the machine for the actual scan.
An MRI will be issued by a doctor. Usually, a doctor will conduct a physical exam and then order a standard X-ray. If the X-ray doesn't show the problem, a doctor will usually order an MRI. However, if a doctor suspects that the symptoms show an issue that won't be picked up in a standard X-ray, they will skip this step and go ahead and order an MRI after the physical exam.