Generally no.
Yes, a doctor may recommend an imaging test, such as an X-ray, ultrasound, or MRI but these are generally not necessary!
When to get a scan
- You have shoulder pain that doesn’t improve with physical therapy over a 6-12 week period
- Your physiotherapist thinks its necessary to determine the cause of treatment that you need
- X-ray: Rules out fractures, bone spurs or osteoarthritis
- Ultrasound: Creates a picture of the tendons and muscles in your shoulder, and can be used to monitor them while you move your arm
- MRI: Creates a picture of the soft tissue in your shoulder, including the muscles, bones, and connective tissue.
What the scan helps with
- Diagnosing a rotator cuff injury
- Determining if the tear is partial or full thickness
- Assessing the extent of the tear and how repairable it is
- Planning surgical treatment
Early diagnosis and treatment can help prevent loss of strength and motion.
How is a rotator cuff injury diagnosed?
Your physio will ask you about your symptoms and what makes them better or worse. They will also ask about your general health and activity level.
Your physio will examine your shoulder. They may ask you to do certain arm movements to see if these cause any difficulty or pain.
In many cases, further tests are not needed to make the diagnosis.
In some cases, imaging tests may be recommended. These may include:
- x-rays — to make sure you don’t have any other reason for your shoulder pain
- an ultrasound scan
- an MRI scan — to examine your rotator cuff in detail if you are not getting better with treatment
What is the difference between X-ray, ultrasound, CT and MRI scans?
X-rays, ultrasounds, CT scans and MRI scans are different imaging techniques used for investigating the structures within the body. Each technique has its indications and limitations.
An X-ray is the oldest imaging technique available and is still excellent for looking at bones and calcified tissue. It is non-invasive and not painful. It gives a 2-dimensional image and often 2 or more views of the same body part are needed. X-rays are great for looking at fractures of the bones. The main disadvantage is that it does not show the soft tissues such as muscles and ligaments and a small amount of ionising radiation is used.
Ultrasound scans are non-invasive and not painful. They are useful for looking at structures closer to the skin. Sound waves are used to image the superficial structures as they only penetrate about 4-5cm deep. The advantage of ultrasound scans is that you can move the body part so you get an idea of how it behaves dynamically. Also you can give a diagnostic or therapeutic injection using ultrasound as a guide.
A CT scan is great for studying the structure of bones in 3-dimensions. It is useful for when there is a fracture with several fragments that have been displaced. It is also used to investigate if there is healing and new bone formation across a fracture site. The disadvantage of a CT scan is that the image is static and radiation required.
The MRI scan is excellent for looking at deep tissues and soft tissues such as the rotator cuff muscles around the shoulder. MRI is a non-invasive procedure that does not require any incisions or injections. It is also painless and does not use ionising radiation, making it a safe option for most patients. The main disadvantage is that the body is kept still during this investigation.
Contact us or book online today to get your shoulder pain back under control!
J. Press
Physiotherapist