Shoulder Mri Scan in Delhi by Dr Shekhar Shrivastav

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The document discusses MRI findings of the normal and pathological shoulder. It begins by showing coronal, sagittal, and axial views of the normal shoulder anatomy. It then describes common shoulder issues seen on MRI such as impingement, rotator cuff pathology including tendinosis, partial and full thickness tears, instability including Bankart lesions and Hill-Sachs deformities, SLAP tears, biceps pathology, fractures, and infection. For each condition, it highlights the MRI features including location and characteristics of lesions. In conclusion, it emphasizes the importance of MRI in evaluating shoulder problems but notes findings must be consistent with clinical examination.

Health & Medicine Technology

MRI SHOULDER
WHAT TO SEE
DR SHEKHAR SRIVASTAV
Sr. Consultant- Knee & Shoulder Arthroscopy

Sant Parmanand Hospital
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Normal Anatomy

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Normal Shoulder MRI

Coronal Oblique
Sagital Oblique
Axial Cuts
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Normal Coronal Oblique
Parallel to plane of
Supraspinatus
• Supraspinatus
• A-C Joint
• Sub-acromial & Sub-Deltoid

bursa

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• Labrum- Sup & Inf
• Biceps Tendon
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Normal Coronal Oblique

• d

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Normal Coronal Oblique

• Parallels the central tendon of supraspinatus

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Normal Sagittal Oblique
Perpendicular to the
plane of Supraspinatus
• Medial to Lateral
• Coraco-acromial arch
• Rotator cuff
• Shape of Acromion
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Normal Sagittal Oblique

• a

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Normal Axial Cuts

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Normal Axial Cuts
• Labrum- Ant & Post
• Gleno-humeral ligament
• Gleno-humeral cartilage
• Biceps Tendon
• Subscapularis & Teres
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Minor
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Arthrogram
Sequence
• Distension of joints,

crowded structures seen

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separately Labrum, G-H

ligaments, biceps anchors
• Partial articular surface RC

tears
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• SLAP tears

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Pathological process Shoulder
• Impingement

• Rotator cuff pathology
• Instability

• Miscellaneous- Biceps, Infection, Adhesive
Capulitis
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Osseous Acromial Outlet

• A-C joint
• Acromion

• Humeral Head
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Extrinsic
Impingement
• A-C osteophytes

• Sub-acromial

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Enthesophytes

• Acromion Shape
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Acromion Shape

3 types

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Type1

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Type 2
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Type 3

Rotator Cuff Pathology

• Tendinosis
• Partial thickness Cuff Tears

• Full thickness Cuff Tears

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Tendinosis
• Thickened tendon with
degeneration

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• Intrasubstance
degeneration
• Normal to intermediate
SI changes

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Partial Cuff Tears
Three types
• Articular side- FP, CZ

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• Interstitial
• Bursal side
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Partial RC Tear

• Intrasubstance tear
• Bursal sided RC Tear
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Bursal Tear

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Intra-Substance Tear
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Full thickness RC tears
• Tear extending from bursal to articular surface
• Fluid in SA-SD bursa
• Retraction of tendon

• Muscle undergoes
Atrophy
Degeneration
Fatty Infiltration

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Full Thickness RC Tears

• Tendons involved
• Size of the tear- AP & ML plain

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Full Thickness RC Tears

• Muscle Atrophy

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Instability
Spectrum ranging from subtle instability to frank

dislocation
• Anterior Instability

• Posterior Instability
• SLAP tear
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Anterior
Instability
• Bankart Lesion

• Bony Bankart

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• Glenoid Erosion

• Hill Sach s lesion
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Anterior Instability

• Bankart Lesion

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Anterior Instability

• Bony Bankart

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Bony Bankart

Glenoid Erosion

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Glenoid Erosion
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Anterior Instability

• Hill Sach s LesionPostero-Sup aspect

of Humeral Head
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Anterior Instability

• Hill Sach s Lesion

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Posterior Instability
• Posterior Labral
Lesion
• Reverse Hill Sach s
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SLAP Tear
• Superior Labrum

Antero-Posterior
Tear

• Avulsion Biceps
Anchor

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SLAP Tear

• Normal Biceps Anchor

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SLAP Tear

• Torn labral

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Biceps Pathology
• Tendinosis
• Rupture
• Dislocation

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Miscellaneous

Osteonecrosis

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• Fractures

Osteonecrosis

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Infection
Occult Fractures

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• Shoulder is a complex joint with many normal
variants
• Proper clinical examination and probable clinical
diagnosis
• MRI very sensitive test for diagnosing shoulder
problems
• MRI findings should corroborate clinical findings
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Various lesions seen in Dislocation Shoulder
ALSPA

Perthes Lesion

Chondral Defect

Reverse Hillsachs &
Post Labral tear

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Rotator Cuff
• Supraspinatus
• Infraspinatus
• Teres minor
• Subscapularis
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Partial Cuff Tears

• Articular sided cuff tear

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Miscellaneous

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Infection

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Adhesive Capsulitis
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