Diagnostic Imaging of the Shoulder: Difference between revisions
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== Introduction == | == Introduction == | ||
Diagnostic Imaging can be a useful resource for musculoskeletal conditions and where used appropriately can be an invaluable tool for physiotherapists. Imaging such as MRI, X-ray, CT Scans, and Bone Scans are prime examples of practical diagnostic imaging that facilitates accurate diagnosis, prognosis, intervention, and assessment of injuries and dysfunction that physiotherapists' address daily. Unnecessary imaging will not only potentially squander financial resources and increase potential for premature surgery, but may also lead to increase failure of conservative physiotherapy treatment as a result of patient expectations following diagnostic imaging e.g. perception that if a tear is there then physiotherapy has no role to play, so it is key to understand and recognise when imaging is appropriate.<ref>Van Tulder MW, Tuut M, Pennick V, Bombardier C, Assendelft WJJ. Quality of primary care guidelines for acute low back pain. Spine. 2004;29(17):E357-62. Available at: [https://www.ncbi.nlm.nih.gov/pubmed/15534397 http://www.ncbi.nlm.nih.gov/pubmed/15534397].</ref> While there are a number of studies which indicate diagnostic imaging is underutilized such as x-rays identifying fractures or bone scans identifying osteoporosis<ref>Freeborn DK, Shye D, Muttooty JP, Eraker S, Romeo J. Primary Care Physicians ’ Use of Lumbar Spine. Journal of General Internal Medicine.3-9.</ref>, there are also many more studies which suggest over utilization of imaging, such as X-rays or MRI for acute and uncomplicated shoulder pain.<ref>Carey TS, Garrett J, Back C, Project P. Patterns of Ordering Diagnostic Tests for Patients with Acute Low Back Pain. Medicine. 1996.</ref> While a thorough history and physical examination are the most important instruments in evaluating shoulder pain, musculoskeletal imaging can be an important adjunct.<ref>McMahon KL, Cowin G, Galloway G. Magnetic resonance imaging: the underlying principles. The Journal of orthopaedic and sports physical therapy. 2011;41(11):806-19. Available at: [https://www.ncbi.nlm.nih.gov/pubmed/21654095 http://www.ncbi.nlm.nih.gov/pubmed/21654095]. Accessed March 16, 2012.</ref> We will review the options and principles of shoulder investigations as they can be a critical element in efficient management in some cases of shoulder pain. | |||
== | == Imaging Options == | ||
=== X-Ray === | |||
=== Arthrography === | |||
=== Ultrasound === | |||
=== MRI === | |||
== Summary == | |||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 02:51, 20 January 2018
Original Editor - Naomi O'Reilly
Top Contributors - Naomi O'Reilly, Kim Jackson, Rucha Gadgil, Admin, Wanda van Niekerk and Lucinda hampton
Introduction[edit | edit source]
Diagnostic Imaging can be a useful resource for musculoskeletal conditions and where used appropriately can be an invaluable tool for physiotherapists. Imaging such as MRI, X-ray, CT Scans, and Bone Scans are prime examples of practical diagnostic imaging that facilitates accurate diagnosis, prognosis, intervention, and assessment of injuries and dysfunction that physiotherapists' address daily. Unnecessary imaging will not only potentially squander financial resources and increase potential for premature surgery, but may also lead to increase failure of conservative physiotherapy treatment as a result of patient expectations following diagnostic imaging e.g. perception that if a tear is there then physiotherapy has no role to play, so it is key to understand and recognise when imaging is appropriate.[1] While there are a number of studies which indicate diagnostic imaging is underutilized such as x-rays identifying fractures or bone scans identifying osteoporosis[2], there are also many more studies which suggest over utilization of imaging, such as X-rays or MRI for acute and uncomplicated shoulder pain.[3] While a thorough history and physical examination are the most important instruments in evaluating shoulder pain, musculoskeletal imaging can be an important adjunct.[4] We will review the options and principles of shoulder investigations as they can be a critical element in efficient management in some cases of shoulder pain.
Imaging Options[edit | edit source]
X-Ray[edit | edit source]
Arthrography[edit | edit source]
Ultrasound[edit | edit source]
MRI[edit | edit source]
Summary[edit | edit source]
References[edit | edit source]
- ↑ Van Tulder MW, Tuut M, Pennick V, Bombardier C, Assendelft WJJ. Quality of primary care guidelines for acute low back pain. Spine. 2004;29(17):E357-62. Available at: http://www.ncbi.nlm.nih.gov/pubmed/15534397.
- ↑ Freeborn DK, Shye D, Muttooty JP, Eraker S, Romeo J. Primary Care Physicians ’ Use of Lumbar Spine. Journal of General Internal Medicine.3-9.
- ↑ Carey TS, Garrett J, Back C, Project P. Patterns of Ordering Diagnostic Tests for Patients with Acute Low Back Pain. Medicine. 1996.
- ↑ McMahon KL, Cowin G, Galloway G. Magnetic resonance imaging: the underlying principles. The Journal of orthopaedic and sports physical therapy. 2011;41(11):806-19. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21654095. Accessed March 16, 2012.
