Shoulder MRI and Arthrogram

For Members:

• What is MRI?
  • Magnetic resonance imaging (MRI) is a radiation-free, non-invasive, technique that uses strong magnetic fields to produce high quality, detailed and sectional images of the inside of the body in multiple planes.
  • The magnetic fields and radio waves used during MRI scan are not harmful. Multiple Researches has confirmed that MRI scans are one of the safest medical procedures available.
  • MRI can detect fractures that are not visible on X-rays and major ligament/tendon damage to important structures inside a joint.
  • It is a painless and safe procedure; anaesthesia or sedation is not needed usually.
  • It can be performed with or without contrast (dye). Usually, contrast agents are used to highlight vascular structures and to help characterize inflammation and tumors. Your Physician will inform you if contrast is being used and an allergy test might be performed for contrast before the MRI.
  • Some tattoo ink contains traces of metal, if you have a tattoo on body and feels uncomfortable or burning sensation then immediately informed your radiologist.

• What are the General Indications for MRI Shoulder?
  • Suspected rotator cuff tear or sprain.
  • Trauma and diffuse axonal injuries.
  • Shoulder instability.
  • Osteonecrosis.
  • Tumors and masses.
  • Infection.
  • Degenerative joint disorders such as arthritis and labral tears.
  • For needle phobic patients who cannot tolerate an arthrogram.

• When MRI is NOT indicated for Shoulder:
  • Frozen shoulder is a clinically diagnosed (age, gender & history) and does not need any specific diagnostic scans.
  • For the frozen shoulder the MRI is not generally helpful. The arthrogram is more helpful because it shows small joint space (i.e. less than 14 ccs).

• What is Arthrogram?
  • It is a type of imaging, which is also called Arthrography.
  • Arthrography can be used to view torn ligaments and fragmented cartilage in the joint.
  • First, using a thin long needle, a special dye, called contrast dye, is injected into your joint directly.
  • Then, the joint is scanned using X-ray, CT scan or MRI.
  • The dye helps in highlighting the problem in your joint.
  • Later, the fluid may be aspirated and sent to a lab for analysis.
  • During the same procedure, medication may be injected into the joint as treatment.
  • The arthrogram is diagnostic of acute full thickness rotator cuff tears more so than MRI only.
  • Other than acute, full thickness rotator cuff tears, all other types of rotator cuff tears, i.e., smaller or incomplete tears are treated based on non-responsiveness to conservative care.
  • Mostly arthrography is used to examine the knee and shoulder joints, it can also be used to examine other small joints, such as the wrist, ankle, hip, elbow or prosthetic joints.

• What are the General Indications for Arthrogram?
  • Rotator cuff tear—mainly for complete tears.
  • Adhesive capsulitis.
  • Rotator interval tear.
  • Glenoid labrum tear.
  • Septic arthritis.
  • Prosthetic loosening or infection.
  • Part of MR arthrogram.
  • Biceps tendon injury.

For Healthcare Providers:

 All MRI require pre-approval from Nextcare.

• Always submit detailed history of the sign & symptoms with onset and duration of the disease.
• In case of Shoulder pain without trauma, kindly provide:
• Onset and duration of the current condition.
• Conservative management provided, with duration and response.
• Complete physical examination and neurological findings.

References:

• https://www.webmd.com/arthritis/what-is-an-arthrogram
• https://www.nhs.uk/conditions/mri-scan/
• https://www.msdmanuals.com/professional/neurologic-disorders/neurologic-tests-and-procedures/magnetic-resonance-imaging-mri-in-neurologic-disorders?query=MRI%20Brain
• https://www.msdmanuals.com/home/bone,-joint,-and-muscle-disorders/diagnosis-of-musculoskeletal-disorders/tests-for-musculoskeletal-disorders?query=arthrography#v37122810
• https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/arthrography