Version June 2024
| Imaging modality | Indications | Limitations |
| Radiography (also called plain film or X-ray) | Initial choice for all shoulder pathology Often the only modality needed for:
| Detection of:
|
| CT | Preoperative evaluation of intra-articular fractures Post arthroplasty evaluation | Limited soft tissue evaluation Detection of bone marrow edema |
| MRI | Best modality for detecting soft tissue pathologies Evaluation of bone marrow | Lower sensitivity for evaluation of shoulder instability/labral tear compared with MR arthrography |
| Technetium 99m bone scan | Infection after arthroplasty (shoulder imaging) Suspected metastases (whole body imaging) | Lack of anatomic localization and resolution |
| Arthrography – Images are acquired after percutaneous injection of contrast into the joint | ||
| Conventional radiography | Diagnosis and treatment of frozen shoulder (adhesive capsulitis) | Invasive |
| MR arthrography | Procedure of choice for evaluating shoulder instability/labral tear High suspicion of rotator cuff tear with normal MRI | Invasive |
| CT arthrography | Rotator cuff tear, when MRI is not available or is contraindicated Shoulder instability/labral tear when MR arthrography is not available or is contraindicated | Invasive Lower sensitivity for evaluation of shoulder instability/labral tear compared with MR arthrography |
| Ultrasonography | Evaluation of:
| Diagnostic performance not generalizable as the technique is highly operator dependent Modality is not widely available as on-site operator expertise is required Limited evaluation of very small or very large (>3 cm) tears and for partial thickness tears Limited evaluation of the labrum and bony structures |
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