How do doctors tell if you tore your rotator cuff?

Answered by John Hunt

Doctors use a combination of imaging tests to determine if you have torn your rotator cuff and to assess the severity of the tear. The two main imaging tests used are X-rays and MRI scans.

X-rays are typically the first test ordered because they can help rule out other causes of shoulder pain, such as bone spurs or osteoarthritis. X-rays are useful for visualizing the bones in the shoulder joint and can show any abnormalities, fractures, or signs of degenerative changes. However, they do not provide a clear view of the soft tissues, such as the rotator cuff tendons.

If an X-ray does not reveal any bone abnormalities, an MRI scan is usually ordered to evaluate the soft tissues in the shoulder, including the rotator cuff. MRI stands for magnetic resonance imaging and uses a powerful magnetic field and radio waves to create detailed images of the inside of your body.

During an MRI scan, you will lie on a table that slides into a cylindrical machine. It is important to remain still during the scan to prevent blurring of the images. The machine may make loud banging or buzzing noises, so you may be offered earplugs or headphones to help block out the noise.

The MRI scan provides your doctor with high-resolution images of the shoulder joint, allowing them to assess the integrity of the rotator cuff tendons. It can determine if there is a tear present and also provide information on the size, location, and severity of the tear. MRI scans can distinguish between partial and full-thickness tears, which is crucial for determining the most appropriate treatment plan.

In some cases, your doctor may also order an arthrogram, which is a type of MRI where a contrast dye is injected into the shoulder joint before the scan. This allows for even greater visualization of the soft tissues and can help identify smaller tears or areas of inflammation.

It is important to note that while imaging tests like X-rays and MRI scans are valuable tools in diagnosing a rotator cuff tear, they should be used in conjunction with a thorough physical examination and a detailed medical history. Your doctor will also consider your symptoms, such as pain and loss of function, when making a diagnosis.

In some cases, your doctor may also perform other tests, such as a shoulder ultrasound or a CT scan, to further evaluate the extent of the injury or to assess for any associated injuries, such as bone fractures.

It is worth mentioning that while imaging tests can provide valuable information, they do not always correlate with the symptoms experienced by the patient. Some individuals may have a small tear but experience significant pain and functional limitations, while others may have a large tear but minimal symptoms. Therefore, the clinical evaluation by your doctor is essential in determining the appropriate course of treatment.

The use of imaging tests, such as X-rays and MRI scans, plays a crucial role in diagnosing a rotator cuff tear and determining the severity of the injury. These tests provide detailed images of the shoulder joint and its soft tissues, allowing your doctor to make an accurate diagnosis and develop an appropriate treatment plan.