CT Scans for Shoulder Injuries and Shoulder Pain

Featuring Dr. Audrey Spielmann, MD, FRCPC

Duration: 3 minutes, 12 seconds

Shoulder injuries are very common in many sports.

We see it often for direct impact, and if athletes have fallen, they can sustain shoulder dislocation and fracture. And so we see that in hockey players, skiers and other contact sports such as football and soccer as well as rugby.

The CT scan highlights the bone issues with shoulder injuries, so we see the fractures to the best degree. The advantage of CT, especially these days where the technology is improved, is that we can image the shoulder with such thin slices and then do 3D reconstructions.

So I just want to show you a case here, this is a young patient who sustained a dislocation and a fracture. And this is the 3D image of the fracture. This is the fracture that has been sustained in the anterior aspect of the glenoid labrum - or the glenoid fossa, the bony structure or socket that holds the shoulder in place.

And we can see the fracture fragment here and if I rotate this image around we see the fracture nicely. CT allows us to do very thin cuts through the bone and then reconstruct the image in multiple different planes as well as do a 3D reconstruction.

And we see the fracture here within the bony glenoid. I can rotate this image around the humeral head, which normally is located here, has been removed to visualize this fracture better so I can just rotate this image around to highlight the socket of the shoulder and visualize the fracture fragment anteriorly.

We can also then look at the humeris that we've removed electronically and see that there is a defect here where the humeris has impacted against the glenoid. This is called a Hill-Sachs defect. And the other lesion that I was highlighting within the bony glenoid is called a Bankart lesion.

The benefit of CT scan is the detail is much greater than with plain X-ray, and we can identify very subtle fractures with CT, do the reconstructions to determine the full extent of it.

CT is really complementary with MRI, where we, and we often perform both CT and MRI in sports injuries. The CT scan to look for the bony component, such as the bony Bankart injury and the MRI to  look for the soft tissue component such as the labral tear that is, accompanies the bony Bankart injury. If you have any questions on CT of the shoulder, contact your family doctor, your sports medicine specialist or an imaging center.

Presenter: Dr. Audrey Spielmann, Radiologist, Vancouver, BC

Local Practitioners: Radiologist