Evaluation of the Efficiency and Effectiveness of MRI in the Diagnosis of Chronic Shoulder Pain

Abstract

Objective: This study aimed to evaluate MRI efficiency in diagnosing chronic shoulder pain causes. Chronic shoulder pain accounts for 5% of musculoskeletal consultations. Method: Thirty-four chronic shoulder pain patients (18-65 years) underwent shoulder MRI. Sequences included T1-weighted, T2-weighted, proton density, and STIR for comprehensive analysis. All patients were clinically diagnosed with chronic shoulder pain prior to imaging. Finding: One patient (1.96%) had normal MRI findings. Thirty-three patients (98.04%) had abnormalities. Rotator cuff injuries were most prevalent, especially partial supraspinatus tears (18.63%). Other findings included bursitis, joint effusion, AC arthropathy, Hill Sachs deformity, AC joint impingement, rotator cuff fatty atrophy, and biceps tendinopathy. Conclusion: MRI provided excellent visualization of soft tissue pathologies causing chronic shoulder pain, noninvasively without ionizing radiation. Combining MRI sequences accurately diagnosed various shoulder conditions. Fat suppression sequences were key for identifying rotator cuff tears. MRI is the gold standard for diagnosing rotator cuff injuries, the most common chronic shoulder pain cause. Novelty: This study demonstrates MRI's utility for evaluating chronic shoulder pain causes. While no single sequence visualizes all shoulder pathologies, using T1-weighted, T2-weighted, proton density, and STIR sequences together provides a comprehensive analysis to guide appropriate patient treatment. Keywords MRI, Chronic shoulder pain, Rotator cuff, Joint effusion, frozen shoulder