How to make sense of shoulder MRI: determining when to treat and when to refer.

Challenges in using MRI in shoulder evaluation include defining the indications for ordering a scan, interpreting the findings, and determining which abnormalities require treatment. Determination of the presence or absence of recent trauma is the most important part of the history. Radiography displays some features of the bony anatomy better than MRI. Several MRI findings increase with age and do not require attention unless they can be established as the source of pain. Acromioclavicular arthritis found on MRI often does not require treatment. Evaluation of the labrum with magnetic resonance arthrography may be more accurate than with MRI. Relating clinical history and physical examination findings with those of the MRI examination is particularly important for rotator cuff evaluation. [ABSTRACT FROM AUTHOR]