Tuite Michael J, Small Kirstin M
1 Department of Radiology, University of Wisconsin, Box 3252, 600 Highland Ave, Madison, WI 53792-3252.
2 Department of Radiology, Brigham and Women's Hospital, Boston, MA.
AJR Am J Roentgenol. 2017 Sep;209(3):525-533. doi: 10.2214/AJR.17.18085. Epub 2017 May 24.
A variety of radiographic views have been described in the literature for the initial imaging of nonacute shoulder pain. Multiple articles have also discussed the best next imaging test if radiographs do not show the diagnosis, especially the use of unenhanced MRI, MR arthrography, CT arthrography, and ultrasound. The purpose of this article is to examine the evidence for the most helpful radiographic views and the best imaging test after radiographs for different clinical presentations of chronic shoulder pain.
The recommended radiographic views and best next imaging test after the radiograph depends on the clinical diagnosis. Ultrasound is generally preferred over MRI for evaluating chronic rotator cuff pain, whereas MR arthrography, preferably with abducted and externally rotated images, is most accurate for imaging chronic symptoms from a suspected labral tear or instability.
文献中描述了多种用于非急性肩部疼痛初始成像的X线视图。如果X线片未显示诊断结果，多篇文章还讨论了最佳的下一步成像检查，尤其是未增强MRI、磁共振关节造影、CT关节造影和超声的应用。本文的目的是研究针对慢性肩部疼痛的不同临床表现，最有用的X线视图以及X线片之后最佳成像检查的证据。
推荐的X线视图以及X线片之后的最佳下一步成像检查取决于临床诊断。在评估慢性肩袖疼痛时，超声通常比MRI更受青睐，而磁共振关节造影，最好是外展和外旋图像，对于疑似盂唇撕裂或不稳定引起的慢性症状成像最为准确。
