title: Overutilization of shoulder magnetic resonance imaging as a diagnostic screening tool in patients with chronic shoulder pain.
abstract: This was a retrospective study of 101 consecutive patients (104 shoulders) with chronic, atraumatic shoulder pain who were evaluated by a fellowship-trained shoulder specialist. The patients were assessed with a complete history, physical examination, plain radiographs, Simple Shoulder Test, and visual analog scores of pain, shoulder function, and quality of life. Forty-one percent of the shoulders presented with shoulder magnetic resonance imaging (MRI). Data analysis was performed to determine the effect of pre-evaluation MRI on patient treatment and outcome. There were no statistically significant differences in age, sex, affected shoulder, insurance status, mechanism of injury, comorbid conditions, range of motion, treatment, initial outcome parameter assessments, or improvement of outcomes between the patients who had pre-evaluation MRI and those who did not. The majority of the pre-evaluation MRI scans had no impact on the outcome. Routine pre-evaluation with MRI does not appear to have a significant effect on the treatment or outcome and should not be used as a screening tool for atraumatic shoulder pain before a comprehensive clinical evaluation of the shoulder.
authors.affiliation: Shoulder Service, Department of Orthopaedic Surgery, Brown Medical School, Rhode Island Hospital, Providence, RI 02905, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bradley
authors.forename: Glenn
authors.initials: G
authors.lastname: Tung
authors.forename: Andrew
authors.initials: A
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010808:Physical Examination; D011788:Quality of Life; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint / Q000503:physiopathology; D020069:Shoulder Pain / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology