Melbourne Radiology Clinic

Sunday
Jun 25th

Shoulder Injuries

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Sports Radiology - Injuries of the Shoulder

Shoulder injuries are common in athletes of all ages. Instability leading to dislocation (or near dislocation, known as subluxation) typically occurs in young people and is usually following a single traumatic episode, such as being tackled during a football game, or falling on an outstretched arm. Identifying which structures are injured and quantifying the degree of injury is important as the athlete may be a candidate for surgical repair and this is most accurately done with MRI. If the patient is unable to undergo an MRI, then a CT arthrogram may be used in its place.

Falling onto the point of the shoulder often results in disruption of a small joint above the shoulder known as the acromioclavicular joint, or commonly referred to as the AC joint.

Overuse, or “wear and tear”, injuries in combination with advancing age predisposes the mature athlete to tears of the tendons of the shoulder that stabilises the shoulder that are collectively known as the rotator cuff. The earliest spectrum of tendon injury is degeneration, or tendinosis (previously referred to as “tendinitis”), where daily damage sustained by the tendon exceeds the ability of the tendon’s internal capacity of repair. Further overuse may then lead to the development of partial and full thickness tears which may then progress to the development of partial thickness tears.


MRI - Shoulder Dislocation

1. MRI evaluation following and episode of shoulder dislocation demonstrates focal absence of a specialised cartilaginous structure of the shoulder known as the labrum (circle) with a massive compression fracture of the humeral head (arrows) known as a Hill-Sach's fracture.


MRI of the AC (acromioclavicular joint)

2. MRI of the AC (acromioclavicular joint) demonstrates cyst formation and bone marrow oedema of the clavicle (arrows) consistent with clavicular osteolysis.


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3. CT can be used to assess bone for fractures, focal lesions and in the post-operative patient where metallic hardware has been inserted

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