Selected Unique Clinical Shoulder Signs as Visualized by MRI

Author(s): Caldon Jayson Esdaille, Daniel Marrero, Cato T Laurencin

Shoulder pain is a common musculoskeletal complaint that if severe enough, can contribute significantly to morbidity due to its debilitating and often disabling nature which may leave patients unable to perform activities of daily living. Various etiologies of shoulder pain exist which present with clinical signs and symptoms based on the source of the pathology. Although most shoulder injuries can be diagnosed with a detailed history and physical exam, magnetic resonance imaging (MRI) has become a well-established technique for confirming pathology of the shoulder due to its high diagnostic accuracy. The ability to visualize soft tissue as well as bone morphology has allowed it to become widely utilized across all specialties that manage shoulder pathology; especially in orthopaedics. Radiologists that interpret MR images often describe changes to normal anatomy by utilizing terms that have been well studied and published throughout radiology literature. These terms are referred to as “signs” and are used to assist in diagnosis of a disease by correlation with clinical symptoms. These signs are a key component of the fundamental core of musculoskeletal radiology but are not often discussed or utilized in the field of orthopaedics to assist with a diagnosis. This manuscript will discuss and review the presentation of a selection of unique clinical signs of shoulder pathology that are identifiable with MRI as well as how they are described by musculoskeletal radiologists. The signs discussed within this manuscript are unique due to the fact that although they are more published throughout musculoskeletal radiology literature when compared to orthopaedic surgery and sports medicine literature.