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Fundamentals in Shoulder Radiology

  • Chapter
Shoulder Arthroplasty

Abstract

Radiological imaging of the shoulder can assist in the diagnosis of a wide variety of conditions including normal anatomical variants, fractures, dislocations, and rotator cuff tears. The complex anatomy of the shoulder joint, which is the most active joint in the body, can make radiological investigation difficult. The choice of imaging modality depends on the nature of the suspected pathology and should be guided by clinical history and physical examination. Plain radiography is frequently the initial imaging modality of choice, with more advanced imaging techniques such as ultrasound, computed tomography, and magnetic resonance imaging employed when necessary. This chapter aims to review the imaging modalities used to assess common shoulder pathologies.

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References

  1. Mitchell C, Adebajo A, Hay E, Carr A. Shoulder pain: diagnosis and management in primary care. BMJ. 2005;331(7525):1124–8.

    PubMed  PubMed Central  Google Scholar 

  2. Urwin M, Symmons D, Allison T, et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998;57(11):649–55.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Shanahan EM, Sladek R. Shoulder pain at the workplace. Best Pract Res Clin Rheumatol. 2011;25(1):59–68.

    PubMed  Google Scholar 

  4. Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender. J Bone Joint Surg Br. 1995;77(2):296–8.

    CAS  PubMed  Google Scholar 

  5. Pandya J, Johnson T, Low AK. Shoulder replacement for osteoarthritis: a review of surgical management. Maturitas. 2018;108:71–6.

    PubMed  Google Scholar 

  6. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37(8):691–7.

    PubMed  Google Scholar 

  7. Karl JW, Olson PR, Rosenwasser MP. The epidemiology of upper extremity fractures in the United States, 2009. J Orthop Trauma. 2015;29(8):e242–4.

    PubMed  Google Scholar 

  8. Roux A, Decroocq L, El Batti S, et al. Epidemiology of proximal humerus fractures managed in a trauma center. Orthop Traumatol Surg Res. 2012;98(6):715–9.

    CAS  PubMed  Google Scholar 

  9. Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner JJ. Acromioclavicular joint injuries: diagnosis and management. J Am Acad Orthop Surg. 2009;17(4):207–19.

    PubMed  Google Scholar 

  10. Mettler FA Jr. Essentials of radiology. 3rd ed. Albuquerque, NM: Saunders; 2013.

    Google Scholar 

  11. Nam D, Maak TG, Raphael BS, Kepler CK, Cross MB, Warren RF. Rotator cuff tear arthropathy: evaluation, diagnosis, and treatment: AAOS exhibit selection. J Bone Joint Surg Am. 2012;94(6):e34.

    PubMed  Google Scholar 

  12. Axtell LM, Asire AJ, Myers MH, editors. Cancer Patient Survival. Report Number 5. Washington, DC: US Department of Health, Education and Welfare; 1976.

    Google Scholar 

  13. Dahlin DC. Bone tumors: general aspects and data on 6,221 cases. 3rd ed. Springfield, IL: Charles C Thomas; 1978. p. 156–75.

    Google Scholar 

  14. Rubin P. Clinical oncology: a multidisciplinary approach. 6th ed. Rochester, MN: American Cancer Society; 1983.

    Google Scholar 

  15. Dahlin DC, Ivins JC. Benign chondroblastoma. A study of 125 cases. Cancer. 1972;30(2):401–13.

    CAS  PubMed  Google Scholar 

  16. Enneking WF. Simple cyst. In: Enneking WF, editor. Musculoskeletal tumor surgery. New York, NY: Churchill Livingstone; 1983. p. 1494–513.

    Google Scholar 

  17. Enneking W, Dunham W, Gebhardt M, Malawer M, Pritchard D. A system for the classification of skeletal resections. Chir Organi Mov. 1990;75(1 Suppl):217–40.

    CAS  PubMed  Google Scholar 

  18. Gregory T, Hansen U, Khanna M, et al. A CT scan protocol for the detection of radiographic loosening of the glenoid component after total shoulder arthroplasty. Acta Orthop. 2014;85(1):91–6.

    PubMed  PubMed Central  Google Scholar 

  19. Gerber C, Pennington SD, Nyffeler RW. Reverse total shoulder arthroplasty. J Am Acad Orthop Surg. 2009;17(5):284–95.

    PubMed  Google Scholar 

  20. Roche C, Flurin PH, Wright T, Crosby LA, Mauldin M, Zuckerman JD. An evaluation of the relationships between reverse shoulder design parameters and range of motion, impingement, and stability. J Shoulder Elb Surg. 2009;18(5):734–41.

    Google Scholar 

  21. Verhofste B, Decock T, Van Tongel A, De Wilde L. Heterotopic ossification after reverse total shoulder arthroplasty. Bone Joint J. 2016;98-B(9):1215–21.

    CAS  PubMed  Google Scholar 

  22. Monga P, Funk L. Diagnostic clusters in shoulder conditions. Lancashire: Springer; 2017.

    Google Scholar 

  23. Castagno AA, Shuman WP, Kilcoyne RF, Haynor DR, Morris ME, Matsen FA. Complex fractures of the proximal humerus: role of CT in treatment. Radiology. 1987;165(3):759–62.

    CAS  PubMed  Google Scholar 

  24. Delage Royle A, Balg F, Bouliane MJ, et al. Indication for computed tomography scan in shoulder instability: sensitivity and specificity of standard radiographs to predict bone defects after traumatic anterior glenohumeral instability. Orthop J Sports Med. 2017;5(10):2325967117733660.

    PubMed  PubMed Central  Google Scholar 

  25. Cook TS, Stein JM, Simonson S, Kim W. Normal and variant anatomy of the shoulder on MRI. Magn Reson Imaging Clin N Am. 2011;19(3):581–94.

    PubMed  Google Scholar 

  26. McNally EG, Rees JL. Imaging in shoulder disorders. Skelet Radiol. 2007;36(11):1013–106.

    CAS  Google Scholar 

  27. Zlatkin MB, Iannotti JP, Roberts MC, et al. Rotator cuff tears: diagnostic performance of MR imaging. Radiology. 1989;172(1):223–9.

    CAS  PubMed  Google Scholar 

  28. Palmer WE, Brown JH, Rosenthal DI. Rotator cuff: evaluation with fat-suppressed MR arthrography. Radiology. 1993;188(3):683–7.

    CAS  PubMed  Google Scholar 

  29. Helms CA. Fundamentals of skeletal radiology. 4th ed. Durham, NC: Saunders; 2013.

    Google Scholar 

  30. Steinbach LS. MRI of shoulder instability. Eur J Radiol. 2008;68(1):57–71.

    PubMed  Google Scholar 

  31. Mall NA, Kim HM, Keener JD, et al. Symptomatic progression of asymptomatic rotator cuff tears: a prospective study of clinical and sonographic variables. J Bone Joint Surg Am. 2010;92(16):2623–33.

    PubMed  PubMed Central  Google Scholar 

  32. Kim HM, Dahiya N, Teefey SA, Keener JD, Galatz LM, Yamaguchi K. Relationship of tear size and location to fatty degeneration of the rotator cuff. J Bone Joint Surg Am. 2010;92(4):829–39.

    PubMed  PubMed Central  Google Scholar 

  33. Gladstone JN, Bishop JY, Lo IK, Flatow EL. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med. 2007;35(5):719–28.

    PubMed  Google Scholar 

  34. Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004;86-A(2):219–24.

    Google Scholar 

  35. de Jesus JO, Parker L, Frangos AJ, Nazarian LN. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR Am J Roentgenol. 2009;192(6):1701–7.

    PubMed  Google Scholar 

  36. Feldman F. Radiology of shoulder prostheses. Semin Musculoskelet Radiol. 2006;10(1):5–21.

    PubMed  Google Scholar 

  37. Tirman PF, Steinbach LS, Feller JF, Stauffer AE. Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography. Skelet Radiol. 1996;25(8):743–8.

    CAS  Google Scholar 

  38. Neviaser RJ, Neviaser TJ, Neviaser JS. Anterior dislocation of the shoulder and rotator cuff rupture. Clin Orthop Relat Res. 1993;291:103–6.

    Google Scholar 

  39. Neviaser RJ, Neviaser TJ, Neviaser JS. Concurrent rupture of the rotator cuff and anterior dislocation of the shoulder in the older patient. J Bone Joint Surg Am. 1988;70(9):1308–11.

    CAS  PubMed  Google Scholar 

  40. Richards RD, Sartoris DJ, Pathria MN, Resnick D. Hill-Sachs lesion and normal humeral groove: MR imaging features allowing their differentiation. Radiology. 1994;190(3):665–8.

    CAS  PubMed  Google Scholar 

  41. Chang D, Mohana-Borges A, Borso M, Chung CB. SLAP lesions: anatomy, clinical presentation, MR imaging diagnosis and characterization. Eur J Radiol. 2008;68(1):72–87.

    PubMed  Google Scholar 

  42. Snyder SJ, Banas MP, Karzel RP. An analysis of 140 injuries to the superior glenoid labrum. J Shoulder Elb Surg. 1995;4(4):243–8.

    CAS  Google Scholar 

  43. Maffet MW, Gartsman GM, Moseley B. Superior labrum-biceps tendon complex lesions of the shoulder. Am J Sports Med. 1995;23(1):93–8.

    CAS  PubMed  Google Scholar 

  44. Stoller DW. Magnetic resonance imaging in orthapaedics and sports medicine. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007.

    Google Scholar 

  45. Lee JC, Guy S, Connell D, Saifuddin A, Lambert S. MRI of the rotator interval of the shoulder. Clin Radiol. 2007;62(5):416–23.

    CAS  PubMed  Google Scholar 

  46. Bunker TD, Anthony PP. The pathology of frozen shoulder. A Dupuytren-like disease. J Bone Joint Surg Br. 1995;77(5):677–83.

    CAS  PubMed  Google Scholar 

  47. Michelin P, Legrand J, Lee KS, et al. Axillary sonography of the shoulder: an adjunctive approach. J Ultrasound Med. 2018;37(11):2707–15.

    PubMed  Google Scholar 

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Acknowledgment

We thank our scientific medical writer, Megan Griffiths, MA, for her help with editing this book chapter.

Author information

Authors and Affiliations

  1. Imaging Institute, Cleveland Clinic, Cleveland, OH, USA

    Ceylan Colak & Carl S. Winalski

  2. Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA

    Carl S. Winalski

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  1. Ceylan Colak
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  2. Carl S. Winalski
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Editor information

Editors and Affiliations

  1. Orthopaedics & Traumatology, Hacettepe University School of Medicine Orthopaedics & Traumatology, Ankara, Turkey

    Gazi Huri

  2. Department of Orthopedic Surgery, Villa del Sole Clinic and Magna Graecia University of Catanzaro, Catanzaro, Italy

    Filippo Familiari

  3. Orthopedic Department, Chosun University Hospital Orthopedic Department, Gwangju, Korea (Republic of)

    Young Lae Moon

  4. Department of Orthopedics & Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Mahmut Nedim Doral

  5. II Clinica Ortopedica & Laboratory Biomeccanica, IRCCS Istituto Ortopedico Rizzoli - University of Bologna, Bologna, Italy

    Giulio Maria Marcheggiani Muccioli

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Colak, C., Winalski, C.S. (2020). Fundamentals in Shoulder Radiology. In: Huri, G., Familiari, F., Moon, Y.L., Doral, M.N., Marcheggiani Muccioli, G.M. (eds) Shoulder Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-030-19285-3_14

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  • DOI: https://doi.org/10.1007/978-3-030-19285-3_14

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-19284-6

  • Online ISBN: 978-3-030-19285-3

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