Efficacy of Repeat Shoulder Magnetic Resonance Imaging

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Magnetic resonance imaging (MRI) is frequently used in the assessment of patients with shoulder pain. Occasionally physicians will obtain a repeat MRI in a shoulder that has not had surgical intervention. The purpose of this study was to determine if a repeat shoulder MRI is efficacious.

All shoulder MRIs (1252 studies) performed at the University of Texas Medical Branch from May 31, 2001 through December 4, 2006, were included in this review; patients with a surgical intervention prior to repeat MRI were excluded. A total of 19 patients with 22 shoulders (1.6% of all shoulders) were identified; initial and repeat shoulder MRI findings were compared to determine if changes in pathology could be detected.

In 12 (54%) of the 22 shoulders studied, significant progression of pathogy was noted between the initial and repeat MRI. The initial MRI did not depict a rotator cuff tear in 17 patients, while a subsequent MRI was remarkable for a cuff tear in 8 (47%) of these patients. Furthermore, of the 12 patients demonstrating considerable progression of disease, 4 (33%) had a repeat shoulder MRI within 90 days of the initial study.

Repeat shoulder MRI demonstrated considerable merit in this study despite its retrospective limitations (ie, absence of a standardized criteria for repeat imaging, or the prospect that some patients may have had an additional MRI outside of our institution). Further study is warranted to establish a selection criteria for patients who warrant a repeat shoulder MRI.

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