Today you will find that relying completely on an MRI report could be a fatal mistake on your road to recovery. 

What is a Shoulder MRI?

Magnetic Resonance is an instrumental examination which in fact is a real scan or photograph of our body.

It is achieved through the emission of radiofrequency waves and a magnetic field. Unlike radiography, it does not use ionizing radiation and therefore does not represent any health hazard.

The person is made to lie on his back and, inside a large machine with a cavity, is subjected to a very strong magnetic field.

The emission of radiofrequency waves, drawing relationship with it, produce ” return signals ” from the body which are recorded by the machinery, composing the final three-dimensional image.

In the case of the Shoulder, it is possible in some cases to use a different instrument than the usual one, without the classic central cavity but a circular ring.

In this way, the patient can remain outside, without the need to enter the tunnel. This for many people represents a big advantage when considering the discomfort created, especially in claustrophobic subjects.

What does the shoulder MRI see?

MRI, contrary to what one might think, does not have absolute power and is unable to see everything inside the Shoulder.

With this exam, we are in fact able to see very well the soft tissues such as muscles, tendons, and ligaments. The greater the presence of water in the tissue, the better it will be highlighted by the MRI.

For this reason, joint or muscle effusions can be thoroughly analyzed. Both after trauma and for inflammatory states it can therefore be useful to obtain information on their state of health.

Furthermore, a very important thing to know is that MRI has a high sensitivity, allowing you to observe even the slightest alterations of the tissues.

Pay attention to the term we used: alterations. We will talk about this in more depth later.

Is Shoulder MRI always useful?

As you may have guessed, the answer is no. We explain well why.

MRI is able to see soft tissue very well but not bones as well. Therefore, failing to see everything, its use is not always useful.

In recent years, with the advancement of technology in the medical field, there has been an increase in the use of exams such as MRI. The problem is that it has come to the point of abusing it.

On a daily basis, many instrumental investigations could be avoided if a specialist evaluation of the shoulder was carried out first.

This is the only way to do an exam that can be really helpful in understanding the real cause of the problem.

On the contrary, many times you risk being sidetracked by the report, just because you haven’t asked yourself the correct question first.

The most expensive photograph of your life

Have you ever wondered why the text of the report of this exam is usually very long?

Perhaps you think that only yours is like that, because you have a more serious problem, yet the reason is quite different.

To answer this question we must think of the MRI of the shoulder as a photograph of a landscape, full of details. If this photograph were analyzed and described by an art critic, he would do it in an exhaustive and detailed way.

This is exactly what happens with MRI.

The anatomical image in this case is rich in elements (of which many are absolutely physiological, we add) which are however observed by an expert eye, the radiologist.

In this way, we have the opportunity to have in writing a lot of information on the internal state of the Shoulder to which, however, one must necessarily give the right weight if one does not want to risk being literally sent into confusion.

This is precisely the great danger deriving from the abuse of this examination. Dangerous that, every year, makes doctors and physiotherapists wrong, leading to incorrect diagnoses.

How to give the right weight to what you read

Not knowing how to give proper weight to each of the reported information can only lead to one thing. Coming to an incorrect conclusion!

In fact, you must know that Orthopedic Doctors often have diagnostic biases, sometimes derived from their experience, which leads them to read a report filtering only what reinforces their idea.

Let’s take some examples. Some of the more frequent terms that you too can read with a Shoulder MRI report in your hand are:

• ” Tendon thickening ” or ” partial tear “.
• ” Signs of tendon distress ” or ” tendinosis “.
• “ Pouring ” or “ liquid stratum ”.
• ” Degenerative changes “.
• ” Arthritic picture “.

Terms like these can not only scare but also lead you to think your shoulder is doomed to undergo surgery to fix the problem.

Unfortunately, this is a serious mistake, because not all injured tendons need to be operated on. We have explored this topic in a very comprehensive video that we invite you to watch.

In most cases, these alterations highlighted by a sensitive examination such as MRI are absolutely physiological and normal.

They are in fact also found in people who do not have any shoulder pain. This may surprise you but numerous scientific studies have validated all this.

Knowing how to discriminate what has a cause-effect relationship from what is absolutely physiological is fundamental and decisive in solving your problem!

Keep this concept in mind, because not understanding it, entrusting your health to general practitioners, could cost you a lot of time, energy, and money.

When is it correct to do a shoulder MRI?

The answer is very simple.

When there is a strong suspicion of an injury to the tendons, muscles, or ligaments of the Shoulder which can justify the existing symptoms.

In all other cases it is useless because, as we said before, the cause of the problem is not attributable to structural damage that I can see through this examination.

For this reason, very often the MRI does not give particular results or rather, the results that emerge are interpreted to make them coincide at all costs with the person’s symptoms.

This is even more serious and dangerous because we risk falling into the error of attributing the cause of the pain to a structural alteration that in most cases is not related to the problem.

This, as we have already said, leads to an incorrect diagnosis, useless treatment, and a failure to resolve the problem.

Pros and Cons of Shoulder MRI

What are the advantages and disadvantages of this shoulder exam compared to the others?

The advantages are:

• does not use radiation: this test does not use ionizing radiation (unlike CT and RX), therefore it can be performed more frequently and even in delicate health states such as pregnancy.
• it is well-tolerated: undergoing this examination is neither painful nor invasive.
• he is not an employee operator. The success and the quality of the result do not depend on the experience or skill of the operator, as is the case with ultrasound, for example.

The defects are instead:

• the duration: the execution of the magnetic resonance has a considerable duration compared to the other exams (we speak of at least 20 minutes).
• reporting time: even if today some services do it quickly, it usually takes a few days to get the result.
• the cost: compared to other surveys it has the highest execution cost.
• he sees the skeletal system less well: some problems affecting these structures may not be detected.
• the setting: even if there are “open-air” machines, generally in the less modern ones it is necessary to remain immobile inside a large narrow tube. This represents an obstacle for those suffering from claustrophobia.

Contraindications to Shoulder MRI

In which cases is it contraindicated to do an MRI?

This examination is to be absolutely avoided in the face of all those conditions incompatible with exposure to an important magnetic field such as:

• Presence of pacemakers (some of the new generations are tolerable instead)
• Metal patients or synthetic implants within the body.
• Wearers of prostheses with metal contents in correspondence with the area to be examined.