What does a CT scan of the shoulder joint show, CT scan or MRI - which is better?

CT scan of the shoulder in 3D reconstruction

It is reasonable to perform a CT scan of the shoulder joint if ultrasound and radiography have not been able to clarify the cause of complaints or there are strong suspicions of pathology of the osteoarticular apparatus in this area. This study is useful if there are contraindications to magnetic resonance imaging (MRI). During a CT scan, cross-sectional images of the shoulder are created using X-ray cameras and special software. Computed tomography of the shoulder can be performed natively or with contrast.

What does a CT scan of the shoulder joint show?

Photo of computed tomography of the shoulder joint

The shoulder joint is the most mobile joint in the human body. The huge range of movements leads to its instability, so dislocations and injuries are often recorded. Dislocation of the articular head from its seat increases the likelihood of damage, which often leads to a degenerative process in which the tissues surrounding the joint gradually break down and cease to function normally. What can be found on tomograms? A CT scan of the humerus demonstrates the complexity of the fracture, the displacement of the fragments, and the angle formed by their position. The ability to visualize images in the axial, sagittal and coronal planes, as well as in three-dimensional format, assists in the interpretation of the lesion and preoperative planning.

CT scan of the shoulder allows you to diagnose the following pathological processes:

• infectious damage to the articular apparatus;
• thrombus formation in the vessels of the shoulder joint;
• systemic connective tissue diseases involving the shoulder joint;
• osteoarticular tuberculosis;
• ruptures of tendons, muscles, ligaments;
• post-traumatic injuries (dislocation, subluxation, fracture, sprain, bruise) and complications (osteonecrosis, scar deformities, etc.);
• dystrophic changes in the area under consideration;
• tumor process (including metastatic lesions) in the joint.

The diagnosis is finally verified taking into account the totality of the results of all studies. The effectiveness of therapy is higher after complete diagnosis, and the treatment regimen is directly related to the pathogenetic factor. A CT scan of the shoulder joint allows the doctor to evaluate the bones, soft tissues, and osteoarticular joints and detect abnormalities.

How is a CT scan of the shoulder performed?

Performing an examination involves placing the patient on a sliding table, which will move inside the ring of the CT machine. During the process, you need to lie still, which will allow you to take high-quality pictures.

How long does a shoulder CT scan take?

Tomography of the shoulder joints

takes from a few minutes to half an hour. The exact timing will depend on whether contrast was used or not. In the second case, the procedure takes longer. The radiologist will need some more time to decipher the images, draw up a conclusion and describe the study. After this, you will be given pictures and a report with which you can go to your doctor.

How is a CT scan of the shoulder joints done?

Patient position during examination

You can get a CT scan of the humerus in St. Petersburg in one of the diagnostic centers, in the radiology department of a hospital or clinic, where there is a computed tomograph. You must first make an appointment by contacting the operator through the website form or by phone. It is possible to undergo an emergency examination on the day of treatment.

How is the CT scan of the humerus performed?

The technician will ask you to take a certain position; For additional fixation of the limb, pillows or straps can be used - this will help maintain the correct position and obtain high-quality images. You may also need to hold your breath for a few seconds during short, individual scans to prevent blurry images. From the next room, a technician will use a remote control to move you deep into the tomograph, and the procedure itself will begin, during which special sensors will rotate around the body. For emergency situations during scanning, there is a button at hand to contact the staff. After completion, you need to wait some time for the technician to be convinced of the quality of the tomograms obtained: they must be clear so that the doctor can read them correctly in the future. A typical CT scan takes 5-10 minutes, which is important in the diagnosis of acute traumatic injuries.

Preparing for a shoulder examination

Native CT scan of the humerus is one of the non-invasive imaging tests and does not require special preparation. It is enough to choose loose, comfortable clothes without zippers or metal fasteners, remove jewelry: hairpins, chains, watches, etc. Bra underwire can also lead to the appearance of artifacts in images, so it is better to take care of this in advance. You need to take with you the results of previous examinations and discharge from the hospital, if any. After diagnosis, you can go about your usual activities.

X-ray of the shoulder joint at the Yauza Clinical Hospital

In our hospital, you can take an X-ray of the shoulder joint using the Digital diagnost digital radiographic system (Philips, the Netherlands), which provides:

• high-quality image at maximum research speed due to digital signal transmission;
• convenience of the procedure (flat panel detectors allow you to obtain images in the required projection without moving the patient);
• instant availability of the received images to the attending physician (all images are sent immediately via Wi-Fi to the hospital server).

The study is performed by experienced radiology specialists according to strict international protocols, the results are accepted in any medical institution in the world.

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The article was checked by radiologist M.A. Petrova. , is for general informational purposes only and does not replace specialist advice. For recommendations on diagnosis and treatment, consultation with a doctor is necessary.

Contrasting

Injection of contrast into a vein through a catheter
Contrast significantly improves the clarity of tomograms and allows you to examine the smallest details that are not shown by a simple (native) computer scan, radiography and ultrasound of the shoulder joint. In most cases, intravenous enhancement is not required and its use is reserved for pathological processes suspicious for tumor or bone abscess. If the procedure involves the introduction of a contrast agent, there are certain nuances that you need to know:

• Intravenous injection of a radiopharmaceutical on an empty stomach increases the likelihood of developing vegetative symptoms: dizziness, nausea, drooling. Therefore, before the examination, 30-45 minutes before the examination, you need to have a light snack.
• If you have previously had an allergic reaction to contrast, tell your doctor. The feeling of hot flashes, rapid heartbeat, mild dyspeptic disorders, which disappeared after a few minutes on their own, are considered normal and are not contraindications to contrast.
• Metformin should be discontinued for diabetes mellitus 36 hours before an enhanced CT scan; discontinuation of the drug should be discussed with an endocrinologist.
• Before a contrast examination, even if there has never been kidney disease, a blood test for creatinine is required. Results are valid for 10 days.

When is an MRI of the shoulder recommended?

Magnetic resonance imaging is indicated in the presence of the following symptoms and conditions:

• Received injuries, damage to tendons and ligaments;
• Suspicion of cancer;
• Benign neoplasms;
• Painful sensations localized in the shoulder area, etc.

In addition, an indication for scanning is a condition in which the shoulder joint loses mobility or muscular dystrophy occurs.

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Indications and contraindications

Computed tomography has its indications and contraindications

If alternative imaging methods do not provide comprehensive information or there are contraindications, MRI is a good alternative for establishing a diagnosis. Computer scanning of the shoulder is usually used to assess the condition of the joint after prosthetics, fractures, and dislocations. The doctor may prescribe this study if the patient is bothered by pain in the shoulder, characteristic clicking, limited range of motion, swelling and redness of the skin over the joint.

As with any x-ray, there is some radiation exposure during a CT scan. Its level is absolutely safe for adults if the diagnosis is carried out using a modern high-quality tomograph. During pregnancy, lactation and in childhood under 14 years of age, radiation exposure can have an adverse effect on the body, so it is preferable to do an MRI or ultrasound of the shoulder joint. Computer scanning for this category of people can be performed for health reasons. A woman who does not rule out a desired pregnancy in the early stages should refrain from any x-ray examinations.

There are also restrictions on the patient’s weight: CT is not possible for technical reasons if the body weight exceeds 150 kg.

Contraindications for contrast CT

Modern radiopharmaceuticals have a minimal risk of side effects, but for some patients, enhanced CT scans are not prescribed. Absolute contraindications to the administration of contrast are:

• hypersensitivity reactions (polyvalent allergy, urticaria, Quincke's edema, anaphylactic shock) to the radiopharmaceutical.
• chronic renal failure in the sub- and decompensation stage.

• condition after kidney transplantation, nephrectomy.

In these cases, the question of the possibility of performing computed tomography with the introduction of contrast is decided on an individual basis.

At the diagnostic ]“Magnit”[/anchor] (St. Petersburg) you can do CT and MRI of the shoulder at a time convenient for you. There is a flexible system of discounts, we work 24/7. At night, examination prices are lower. A modern tomograph, high quality images, experienced specialists, an individual approach to each patient - everything that is necessary to determine the cause of the disease.

Alternative Methods

• CT scan of the shoulder joint - allows you to evaluate bone changes, identify the presence of foreign bodies in the joint, a highly accurate method, but with a significant radiation exposure.
• MRI is a study of the structure of periarticular soft tissues, ligaments, tendons and cartilaginous surfaces, but the study is expensive.
• Ultrasound is a safe and accessible method for studying cartilage and soft tissue elements of the joint - synovial membrane, ligaments, periarticular structures (muscles, tendons). Detects inflammatory changes (including rheumatoid arthritis), blood, inflammatory exudate in the joint cavity.

When is contrast needed for a CT scan of the shoulder?

Using contrast to examine the shoulder joint is a fairly rare situation. CT with contrast is performed in cases where it is necessary to differentiate identified pathological foci. Often the doctor makes the decision to administer a contrast agent during the preliminary scan.

Clinics in St. Petersburg use high-quality non-ionic preparations with iodine for contrast. They are well tolerated by patients and rarely cause adverse reactions.

Alternatives to MRI

1. Computed tomography (CT) is a less informative method for diagnosing pathological changes in the shoulder joint. CT scans can only detect significant damage to the joint.
2. MSCT is a sensitive and effective diagnostic method, but it is more suitable for studying damage to bone structures. Ionizing radiation, which is used to perform CT and MSCT, is harmful to the human body.
3. X-ray – allows you to examine only the internal bone structures.
4. Ultrasound is an insufficiently accurate method of rapid diagnosis.
5. PET-CT can detect many functional disorders in the shoulder joint, but is a rather expensive procedure.

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Who should not have the procedure

Tomography is not performed on women throughout pregnancy, since X-ray radiation negatively affects the fetus, causing changes at the genetic level and provoking the manifestation of various disorders in the baby.

An obstacle may be the patient's weight exceeding two hundred kilograms. In Russian clinics, tomographs are designed for precisely this maximum load. There are a number of contraindications that are relevant only for examinations with the introduction of a contrast agent. These include various types of allergies, including iodine intolerance. If a patient experiences an allergic reaction during the examination, the scan will be stopped and the person will be given assistance. All clinics have a stock of antihistamines just for such a case.

It does not recommend the administration of radiocontrast agents to women during lactation, since the dye passes into breast milk. An absolute contraindication to this examination method is kidney disease, which leads to a decrease in kidney function. This prevents the timely removal of contrast from the body and, as a result, general intoxication.

An examination with the introduction of X-ray contrast is not carried out if the patient is in a coma, experiencing anaphylactic or traumatic shock, since it is quite long and requires the patient to be aware of his actions.

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Injuries, sprains, heavy physical labor - all this can disrupt the functioning of the shoulder joint and cause pain. It is quite difficult to accurately diagnose the disease based on the patient’s existing symptoms, since they are largely similar. Without a reliable clarification of the clinical picture, it is impossible to prescribe effective treatment. In this situation, MRI of the shoulder joints is the optimal choice of diagnostic method, since it is characterized by the following undeniable advantages:

• safety;
• painlessness;
• the ability to study in detail each affected area of ​​both bone and soft tissue;
• acceptable cost.

MRI of the shoulder joint is usually prescribed by traumatologists if they suspect a hematoma, dislocation or fracture. For pathological neoplasms in this joint, tomography is also relevant. This study is often used in preparation for surgery, as well as to monitor the patient’s condition during the rehabilitation period. The shoulder joint is characterized by a rather complex structure, so without a specialized study it is impossible to reliably determine which structures in it are damaged. MRI of the shoulder joint provides an opportunity to obtain an accurate picture of what is happening, which expands the capabilities of the treating specialist and helps the patient recover faster.

Contraindications to computed tomography (MSCT) of the shoulder joint

MSCT examination has certain contraindications:

• Pregnancy is a clear contraindication for MSCT.
• Large patient weight, as modern devices have certain weight restrictions.
• Having an allergy to contrast.
• Severe decompensated somatic pathology (renal failure, heart failure, liver failure), especially when tomography with contrast is planned, since contrast can lead to a worsening of the condition.
• When performing tomography with contrast, nursing mothers are not recommended to breastfeed for 48 hours after the contrast study.
• MSCT is not recommended for patients under 14 years of age.

Features of the event

MSCT differs from CT in the equipment used. New generation tomographs are used for multispiral examination. They are equipped with several X-ray tubes and sensitive sensors. The result is accurate and detailed images with minimal cropping. They are easy to scale and visualize in 3D format.

MSCT of the shoulder joint is often prescribed to clarify the results of other diagnostic methods. Using the procedure, it is possible to identify neoplasms, inflammatory processes in the joint and surrounding tissues, the presence of degenerative changes and the consequences of injuries.

The examination does not require specific preparation and is often performed without contrast. It is also better to avoid eating 4-5 hours before the tomography.