Magnetic Resonance Imaging (MRI) of the Shoulder
Magnetic Resonance Imaging (MRI) of the ShoulderSkip to the navigationTest OverviewMagnetic resonance imaging (MRI) is a test
done with a large machine that uses a magnetic field and pulses of radio wave
energy to make pictures of the shoulder. Muscles,
ligaments,
cartilage, and other joint structures are best seen
with an MRI. In many cases MRI gives information about structures in the body
that can't be seen as well with an
X-ray,
ultrasound, or
CT scan. For an MRI test, you are placed
inside the magnet so that your shoulder is inside the strong magnetic field.
MRI can find changes in the structure of organs or other tissues. It also can
find tissue damage or disease, such as infection or a tumor. Pictures from an
MRI scan are digital images that can be saved and stored on a computer for
further study. The images also can be reviewed remotely, such as in a clinic or
an operating room. Photographs or films of selected pictures can also be made.
In some cases, a
contrast material may be used during the MRI scan to
show certain structures more clearly in the pictures. The contrast material may
be used to check blood flow, find some types of tumors, and show areas of
inflammation or infection. The contrast material may be put in a vein (IV) in your arm or directly into your shoulder
joint. You may be able to have an MRI with an open machine that doesn't enclose your entire body. But open MRI machines aren't available everywhere. The pictures from an open MRI may not be as good as those from a standard MRI machine. Why It Is DoneMagnetic resonance imaging (MRI) of the
shoulder is done to: - Check unexplained shoulder
pain.
- Find problems in the shoulder, such as
arthritis, bone tumors, worn-out cartilage, torn
ligaments, torn tendons, or infection. An MRI can detect tears in the cartilage
(labrum) in the shoulder. Labral tears often are caused
by injury and can lead to shoulder pain.
- Find
rotator cuff disorders, including tears and
impingement.
MRI may also help diagnosis a bone fracture when X-rays
and other tests are not clear. MRI is done more commonly than other tests to
check for certain bone and joint problems. How To PrepareBefore your MRI test, tell your doctor
and the MRI technologist if you: - Are allergic to any medicines. The contrast
material used for MRI does not contain iodine. If you know that you are allergic to the contrast material used for the MRI, tell your doctor before having another test.
- Are or might be pregnant.
- Have metal screws in
your shoulder from a past shoulder surgery.
- Have any metal implanted in your body. This helps your doctor know if the test is safe for you. Tell your doctor if you have:
- Heart and blood vessel devices such as a coronary artery stent, pacemaker, ICD (implantable cardioverter-defibrillator), or metal heart valve.
- Metal pins, clips, or metal parts in your body, including artificial limbs and dental work or braces.
- Any other implanted medical device, such as a medicine infusion pump or a cochlear implant.
- Cosmetic metal implants, such as in your ears, or tattooed eyeliner.
- Had recent surgery on a blood vessel. In some
cases you may not be able to have the MRI test.
- Have an
intrauterine device (IUD) in place. An IUD may prevent
you from having the MRI test done.
- Become very nervous in confined
spaces. You need to lie very still inside the MRI magnet, so you may need
medicine to help you relax. Or you may be able to have the test done with open
MRI equipment. It is not as confining as standard MRI machines.
- Have any other health conditions, such as kidney problems or
sickle cell anemia, that may prevent you from having
an MRI using contrast material.
- Wear any medicine patches. The MRI may cause a burn at the patch
site.
You may need to arrange for someone to
drive you home after the test, if you are given a medicine (sedative) to help you relax. You may be asked to sign a consent form that says you understand the risks of the test and agree to have it done. Talk to
your doctor about any concerns you have regarding the need for the test, its
risks, how it will be done, or what the results will mean. To help you
understand the importance of this test, fill out the
medical test information form(What is a PDF document?). How It Is DoneA magnetic resonance imaging (MRI) test
is usually done by an MRI technologist. The resulting pictures are usually
interpreted by a
radiologist. But some other types of doctors, such as
an
orthopedic surgeon, can also interpret a shoulder MRI
scan. You will need to remove all metal objects (such as hearing
aids, dentures, jewelry, watches, and hairpins) from your body because these
objects may be attracted to the powerful magnet used for the test. You will need to take off all or most of your clothes, depending on which
area is examined (you may be allowed to keep on your underwear if it is not in
the way). You will be given a gown to use during the test. If you are allowed
to keep some of your clothes on, you should empty your pockets of any coins and
cards (such as credit cards or ATM cards) with scanner strips on them because
the MRI magnet may erase the information on the cards. During the testDuring the
test, you will lie on your back on a table that is part of the MRI scanner. The
table will slide into the space that contains the magnet. A device called a
coil may be placed over or wrapped around the area to be scanned. Some people feel nervous (claustrophobic) inside the MRI magnet. If
feeling nervous keeps you from lying still, you can be given a medicine
(sedative) to help you relax. Some MRI machines (called open MRI) are made so
that the magnet does not enclose your entire body. Open MRI machines may be
helpful if you are claustrophobic. Inside the scanner, you will hear a fan and feel
air moving. You may also hear tapping or snapping noises as the MRI scans are
taken. You may be given earplugs or headphones with music to reduce the noise.
It is very important to hold completely still while the scan is being done. You
may be asked to hold your breath for short periods of time. During
the test, you may be alone in the scanner room. But the technologist will watch
you through a window. You will be able to talk with the technologist through a
two-way intercom. If contrast material is needed, the
technologist will usually put it in through an IV in your arm or hand.
The injection may be given over 1 to 2 minutes. Contrast material
may be put directly into your shoulder joint by the radiologist. Your doctor
will make your shoulder numb (local anesthetic) before putting in the
contrast material. Then more MRI scans are done for this part of the test. This
is called a magnetic resonance arthrogram. An MRI test usually
takes 30 to 60 minutes but can take as long as 2 hours. How It FeelsYou won't have pain from the magnetic
field or radio waves used for the MRI test. The table you lie on may feel hard
and the room may be cool. You may be tired or sore from lying in one position
for a long time. If a contrast material is used, you may feel some
coolness when it is put into your IV. You may have a squishy feeling
in your shoulder for 1 to 2 days from the material. In rare cases,
you may feel: - A tingling feeling in the mouth if you have
metal dental fillings.
- Warmth in the area being examined. This is
normal. Tell the technologist if you have nausea, vomiting, headache,
dizziness, pain, burning, or breathing problems.
RisksThere are no known harmful effects from the
strong magnetic field used for MRI. But the magnet is very powerful. The magnet
may affect pacemakers, artificial limbs, and other medical devices that contain
iron. The magnet will stop a watch that is close to the magnet. Any loose metal
object has the risk of causing damage if it gets pulled toward the strong
magnet. Metal parts in the eyes can damage the
retina. If you may have metal fragments in the eye, an
X-ray of the eyes may be done before the MRI. If metal is found, the MRI will
not be done. Iron pigments in tattoos or tattooed eyeliner can
cause skin or eye irritation. An MRI can cause a burn with some
medicine patches. Be sure to tell your doctor if you are wearing a
patch. There is a slight chance of an
allergic reaction if contrast material is used during
the MRI. But most reactions are mild and can be treated using medicine.
Contrast material that contains gadolinium may cause a serious problem (called
nephrogenic systemic fibrosis) in people with
kidney failure. If you have decreased kidney function
or serious kidney disease, tell your doctor before having an MRI scan. There also is a slight risk of an infection at the IV site if contrast
material was used. If you breastfeed and are concerned about whether the dye used in this test is safe, talk to your doctor. Most experts believe that very little dye passes into breast milk and even less is passed on to the baby. But if you prefer, you can store some of your breast milk ahead of time and use it for a day or two after the test. If you are pregnant, be sure to tell your doctor. The contrast material that contains gadolinium could be harmful to your baby. ResultsMagnetic resonance imaging (MRI) is a test done with a large machine that uses a magnetic
field and pulses of radio wave energy to make pictures of the shoulder. The
radiologist may discuss preliminary results of the MRI
with you right after the test. Complete results are usually available for your
doctor in 1 to 2 days. An MRI scan can sometimes find a problem in
a tissue or organ, even when the size and shape of the tissue or organ looks
normal. Magnetic resonance imaging (MRI) of the shoulder| Normal: | The muscles, tendons, bones, and joints
look normal in size, shape, and location. |
|---|
No growths, such as tumors, are
present. | No cartilage problems or tears, broken
bones (fractures), or loose bodies are present. | No
rotator cuff injury or tear is present. | No signs of inflammation or infection are
present. | | Abnormal: | A growth, such as a tumor, inflammation,
or infection in the bone or joint is present. |
|---|
A collection of fluid is found, which could
mean you have an infection. | Damage to
ligaments,
tendons, or
cartilage is present. | Joint damage is present and bones may show
signs of disease or fracture. | What Affects the TestReasons you may not be able to
have the test or why the results may not be helpful include: - Metal devices in your shoulder or chest from
previous surgery. These can make the MRI pictures blurry and prevent your
doctor from seeing what is wrong with your shoulder.
- Medical devices that use electronics, such as a
pacemaker or medicine infusion pump. The MRI magnet may cause problems with
these devices.
- If you are not able to remain still during the
test.
- Obesity. A person who is very
overweight may not fit into the opening of some standard MRI machines.
What To Think About- Sometimes your MRI test
results may be different than those from
CT,
ultrasound, or
X-ray tests because the MRI scan is more
specific.
- Other procedures, such as an arthrogram or
arthroscopy, may be used to evaluate shoulder
problems.
- Open MRI machines are now
made so that the magnet does not completely surround you. Open MRI is useful
for people who are claustrophobic or obese. But these machines are not
available everywhere. Also, these machines may not be able to do all the
studies needed to check for problems.
ReferencesOther Works Consulted- Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
- Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
CreditsByHealthwise Staff
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Specialist Medical ReviewerHoward Schaff, MD - Diagnostic Radiology Current as ofNovember 28, 2016 Current as of:
November 28, 2016 Last modified on: 8 September 2017
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