title: [Imaging of the shoulder].
abstract: Clinical history and patient examination are mandatory to correctly order shoulder imaging. The choice of the imaging modality will depend on different factors. Is the shoulder stable or instable? Was there a traumatic history or simply repetitive microtraumas? Is the A-C joint electively tender? Generally, plain X-rays is the first step in the shoulder imaging. However different views will be adapted to the clinical examination. Double oblique standard view in neutral position and rotations with associated profile is the basis of the examination. In the case of a painful stable shoulder, ultrasound is usually the second step. MRI is only necessary in case of deficient ultrasound. If surgery is an option, CT-scan or MRI without any contrast media are useful because ultrasound cannot correctly predict the eventual fatty degeneration of the muscles that contra-indicates the surgical treatment. In the case of shoulder instabilities, there is no place for ultrasound. The best choice is always an intra-articular injection of contrast medium followed by CT-scan or MRI. Only these examinations are able to depict labrum lesions or bicipital desinsertion. Finally, the AC joint must be evaluated separately from the rest of the shoulder with special radiological and ultrasound incidences. Stress or dynamic maneuvers can be added either with X-rays or ultrasound.
authors.affiliation: Service d'Imagerie Médicale, Hôpitaux Iris Sud. ppeetrons@his-izz.be
authors.forename: P
authors.initials: P
authors.lastname: Peetrons
authors.forename: A
authors.initials: A
authors.lastname: Vanderhofstadt
mesh_terms: D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D012785:Shoulder Joint; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography