How to Read Your Shoulder MRI

Introduction

• Speaker: Dr. Centeno
• Purpose: Empower patients to understand shoulder MRI
• Disclaimer: Not a substitute for a radiology report or doctor’s opinion

Understanding MRI Basics

• MRI: 3D picture slicing through the shoulder in three planes:
  • Sagittal: Side view
  • Coronal: Front view
  • Axial: Top-down view
• Focus: Coronal plane (labeled COR)

Key Shoulder Structures in MRI

• Coronal Image: Key Points

  • Main shoulder joint
  • Rotator cuff and its attachment
  • Humerus bone
  • AC joint (Acromioclavicular)

• Top View

  • Collarbone
  • Scapula (shoulder blade)
  • Main shoulder joint
  • Rotator cuff

• Front View

  • Humerus bone
  • Subscapularis (part of rotator cuff)
  • Collarbone

• Back View

  • Teres and infraspinatus muscles (back part of rotator cuff)
  • Supraspinatus (top part of rotator cuff)
  • AC joint

Top Three Areas to Examine

1. AC Joint
   • Check if small/straight or big/distorted
   • Impact on rotator cuff (impingement risk)
   • Indicators of arthritis
2. Rotator Cuff
   • Smooth and continuous or irregular with white spots
   • Signs of fluid or large sections of white indicating swelling/tears
   • Uniform color or splotchy (degenerative tears)
3. Main Shoulder Joint
   • Grey cartilage on both sides
   • Ball-and-socket joint spacing
   • Comparison of joint space and cartilage between normal and arthritic joints

Reading an MRI: Practical Example

• Image Analysis
  • AC joint: Signs of slight pressure on the rotator cuff
  • Rotator cuff tendon: No major tears, mostly dark and appropriately grey
  • Main shoulder joint: Some cartilage thinning but still present
  • Observation: Humerus bone slightly high

Conclusion

• Key Message: Empowering patients with knowledge about their MRI
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