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Pain in the shoulder can occur for various reasons – trauma, joint pathology, bone tissue damage, pinched nerve, and the like. Some pathologies develop secretly – while the person practically does not experience discomfort. Some diseases are accompanied by acute pain and limited movement. If, upon examination by a specialist, standard diagnostic methods do not provide the necessary diagnostic information, the patient is assigned magnetic resonance imaging of the shoulder joint.
This diagnostic method is based on the use of radio waves and magnetic fields. The MRI machine allows you to visualize the damaged area of the body, which makes it possible to establish an accurate diagnosis and proceed to effective treatment.
Operating principle
The basis of the method is an electromagnetic field in which a person is placed, given that every cell of the body contains hydrogen ions that have the ability to create a response impulse in response to electromagnetic fields. It is these pulses that are captured by the MRI machine, and on the basis of these data it is possible to obtain a three-dimensional image of the object under study. Compared to other diagnostic methods that use x-rays, magnetic resonance imaging is safe for the human body.
Scanning of a certain part of the body is carried out in layers. The thickness of the layer is determined by a specialist depending on the individual case and is only a few millimeters. Further, on the basis of all the obtained images, a general information picture is formed and a conclusion is made.
What will an MRI of the shoulder joint show?
When a patient goes to the doctor with complaints of pain in the shoulder joint or limited mobility, magnetic resonance imaging may be prescribed to clarify the diagnosis and find the true cause of the discomfort. A significant advantage of this method is that the image shows not only cartilage and bone tissue, but also vessels, tendons, ligaments and surrounding soft tissues. And the defect of any of these elements will be visible on the obtained layer-by-layer images.
Thus, traumatic injuries can be seen on MRI of the shoulder joint; pathology and lesions of the periarticular bag; the presence of a tumor and metastases; pathology of muscles, ligaments or tendons; anomaly of vessels, nerves and other defects.
At the same time, MRI can be used to monitor the recovery dynamics – when the patient is recovering from a complex injury or operation.
Indications for MRI
Most often, elderly patients, athletes and people whose work activity is associated with constant physical exertion complain of pain in the shoulder joint. But, according to statistics, at this time there is an increase in the number of complaints from young people and even children. The reason for this negative phenomenon lies in the wrong lifestyle, low activity, unbalanced diet. Regardless of the cause of discomfort – trauma or the development of pathology – the patient can be assigned magnetic resonance imaging. The direction for the study can be issued by a traumatologist, rheumatologist or the attending physician.
Indications for issuing a referral for MRI:
- injuries, suspected damage or rupture of ligaments;
- acute or chronic shoulder pain;
- complete or partial loss of mobility;
- fracture or dislocation;
- suspicion of a tumor;
- chronic inflammatory diseases of the joints;
- degenerative diseases;
- rehabilitation period after an injury or surgery.
According to the results of MRI, the attending physician can confirm the preliminary diagnosis or determine the cause of the patient’s complaints.
Preparation for research
Preparation for scanning includes dressing the patient in suitable clothing and removing all metal objects from the body, including removable dentures. If there are non-removable metal implants in the body, it is imperative to inform the specialist performing the diagnosis. The magnetic field can adversely affect the prostheses, displacing them from the established place. It may also affect the outcome of the study.
The patient will certainly be informed that he will be placed in a special tube of the apparatus and will be in rather cramped conditions throughout the study. People who suffer from claustrophobia or increased nervous excitability are prescribed sedatives. Sometimes the presence of claustrophobia makes it impossible to carry out the procedure.
If it is necessary to prescribe magnetic resonance imaging for children under 5 years of age, general anesthesia can be used.
Features of the procedure
The duration of the procedure is 20-30 minutes. The patient lies on a special retractable couch. The head, legs and arms are fixed with special rollers or soft straps, and a special coil is attached to the study area, with the help of which images are obtained – to obtain an accurate result, it is necessary to remain still throughout the scanning process. The couch slides into the tube of the device and scanning begins.
The device emits a loud enough sound during operation, which can cause panic attacks or neurasthenia. With a sharp deterioration in the patient’s condition, the patient can contact the X-ray technician via two-way communication.
The interpretation of the results takes from 30 minutes to several hours, depending on the specific case. The description is made by a radiologist and issued in the form of a preliminary conclusion. The final diagnosis is established by the attending physician.
Using a Contrast Enhancer
Sometimes, for better visualization of changes in the joint and clarification of the diagnosis, an additional study with contrast enhancement may be required.
The duration of scanning with the use of a contrast amplifier is increased by 2 times. Initially, the patient is tested for sensitivity to the contrast used.
Contra-indications and limitations
Magnetic resonance imaging does not have a negative impact on the human body and can be prescribed to almost all categories of patients. But there are also limitations that must be taken into account before the appointment.
If the patient has a pacemaker or neurostimulator, prosthetic heart valves, vascular clips, or surgical staples, magnetic resonance imaging is contraindicated for him.
For pregnant women, MRI can only be prescribed in the 2nd and 3rd trimesters of pregnancy and without the use of a contrast enhancer. If a nursing mother needs a study using a contrast agent, she should wean the baby from the breast for 48 hours.
Chronic renal failure and a history of severe allergic reactions are also a contraindication for the use of a contrast agent.
There are also restrictions on the weight of the patient – they are explained by the size of the tube of the MRI machine. The maximum patient weight is 130 kg.