RadteraMRI Shoulder Without Contrast
MRNo contrastMSK
Indications
- Rotator cuff tear / impingement
- Shoulder pain
- Labral pathology (consider MR arthrogram)
- Biceps tendon abnormality
- Instability
- Mass / AVN
Patient prep
- MRI safety screening
- Shoulder surface coil
- Arm at side in neutral to slight external rotation; thumb up
Contrast
None / non-contrast
Technique
- Supine with affected shoulder in dedicated surface coil, off-center FOV
- Neutral/external rotation; avoid internal rotation (degrades supraspinatus)
- Oblique coronal aligned along supraspinatus tendon; oblique sagittal perpendicular
- Small FOV (~14-16 cm), 3-4 mm slices
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Oblique Cor T2 fat-sat | oblique coronal | T2 FS | 3-4 mm | Supraspinatus tear, AC joint |
| 2 | Oblique Cor T1 or PD | oblique coronal | T1/PD | 3-4 mm | Anatomy, cuff |
| 3 | Oblique Sag T2 fat-sat (or PD FS) | oblique sagittal | T2/PD FS | 3-4 mm | Cuff muscles, fatty atrophy |
| 4 | Ax PD/T2 fat-sat | axial | PD/T2 FS | 3-4 mm | Labrum, biceps, subscapularis |
Key points
- Oblique coronal best for supraspinatus; axial best for labrum and biceps.
- Assess cuff muscle fatty atrophy on sagittal (Goutallier).
- For labral/instability evaluation, direct MR arthrography (dilute gadolinium intra-articular) is more sensitive; ABER positioning helps anteroinferior labrum.
- Internal rotation positioning artifactually mimics cuff pathology—avoid.
References
• ACR-SSR Practice Parameter for MRI of the Shoulder
• Radiopaedia: Shoulder MRI protocol link
• ACR Appropriateness Criteria: Shoulder Pain-Atraumatic
• Radiopaedia: Shoulder MRI protocol link
• ACR Appropriateness Criteria: Shoulder Pain-Atraumatic
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.