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.
Bones
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.
acromioclavicular injury, arthritis, hooked acromion, lateral downslope, os acromiale, acromial apophysiolysis, Geyser sign
Subacromial-subdeltoid bursa
subacromial bursitis, fluid
Rotator cuff
Assessment of the following structures:
infraspinatus tendon and infraspinatus muscle
teres minor tendon and teres minor muscle
subscapularis tendon and subscapularis muscle
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:
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long head biceps tendon
tendinosis, tear, dislocation, tenosynovitis
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:
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joint space
joint effusion if present and possible intra-articular fragment or intra-articular loose bodies
synovia
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middle and inferior glenohumeral ligaments
traumatic injury (HAGL, GAGL), adhesive capsulitis
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labral pathology
anterior and posterior glenolabral injuries, SLAP lesion
Soft tissues
Assessment of deltoid and pectoralis muscles and the subcutaneous fat:
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