Current Protocols for Radiographic and CT Evaluation of the Shoulder

Abstract

Even though imaging trends for the shoulder continue to evolve, standard radiography remains the first-line investigation for most shoulder conditions. Additional nonstandard, more specialized radiographic views, as outlined in this chapter, are useful at demonstrating specific shoulder abnormalities. That said, expected limitations (technical know-how, practicality, and overall information yield) have largely curtailed the use of these views in favor of cross-sectional imaging studies. Overall, MR imaging is the main cross-sectional imaging modality used nowadays to examine the shoulder. CT, however, has distinct advantages over MRI particularly in the assessment of bony trauma. CT is also frequently used to assess other conditions such as glenoid bone loss or severe glenohumeral osteoarthritis prior to surgery as well as prostheses and fixation devices following surgery. As CT arthrography provides most of the relevant information provided by MR or MR arthrography, it is a reliable alternative investigation when MR is contraindicated or unsuccessful. CT arthrography is also very helpful in the assessment of the postoperative shoulder. Recent advances in CT imaging such as dual-energy and iterative CT confer additional advantages.