MRI of the shoulder (an approach)

Last revised by Yoshi Yu on 20 Mar 2024

MRI of the shoulder is one of the more frequent examinations faced in daily radiological practice. This approach is an example of how to create a radiological report of an MRI shoulder with coverage of the most common anatomical sites of possible pathology.

Systematic review

A systematic review in the MRI of the shoulder is essential since shoulder anatomy itself is rather complex, and pathologies and injury patterns are manifold and only rarely lead to an abnormality of a single structure but rather show diverse findings which might need to be addressed in further patient management.


The bony structures of the shoulder, the pictured proximal humerus, the pictured scapula with the glenoid, coracoid process as well as the acromion and the distal clavicle are assessed:

Acromioclavicular joint and coracoacromial arch 

Assessment of the acromioclavicular joint, including acromial shape, downslope, variant anatomy.

Subacromial-subdeltoid bursa
Rotator cuff

Assessment of the following structures:

Precise assessment and description and grading of the rotator cuff pathology (e.g. tendinosis, partial-thickness, full-thickness rotator cuff tear, or calcium deposits) including the shape, extension, and tear dimensions if applicable.

Muscles are assessed with respect to atrophy, fatty degeneration, and edema as a result of a rotator cuff tear or in nerve compression syndromes.

Rotator interval and long head biceps tendon

Assessment of the following structures:

The rotator interval is assessed with respect to biceps pulley injury and in cases of suspected adhesive capsulitis.

Glenohumeral articulation

Assessment of the following structures:

Soft tissues

Assessment of deltoid and pectoralis muscles and the subcutaneous fat:

Common pathology

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