Magnetic resonance imaging of painful shoulder arthroplasty

Specialized magnetic resonance imaging (MRI) was performed in 42 painful shoulder arthroplasties, 22 of which underwent subsequent revision surgery, allowing surgical confirmation of the pathology identified on MRI. One hemiarthroplasty was excluded because of motion artifact, leaving 21 studies (19 patients) to be correlated retrospectively to the surgical findings. At the time of revision surgery, there were full-thickness rotator cuff tears in 11 of 21 shoulders; MRI correctly predicted these in 10 of 11 shoulders. Full-thickness subscapularis tears were the most common finding (8/11 shoulders). Of the 21 shoulders, 10 did not have a rotator cuff tear, and MRI correctly predicted the absence of a tear in 8 of 10. MRI also correctly predicted glenoid cartilage wear in 8 of 9 shoulders. With limited pulse-sequence parameter modification, the data from this preliminary study suggest that MRI may be a useful technique with which to determine the integrity of the rotator cuff and residual cartilage and, thus, is potentially a tool in the management of painful shoulder arthroplasty. (J Shoulder Elbow Surg 2002;11:315-21)