Hodler J
Abteilung Radiologie, Universitätsklinik Balgrist.
Ther Umsch. 1998 Mar;55(3):169-74.
A number of abnormalities of the shoulder joint can cause pain or dysfunction. Imaging of this complex joint is demanding. Standard radiographs are considered to represent the basis of all imaging. For more detailed diagnoses, especially concerning soft tissue, more advanced imaging methods are required. Standard arthrography (without combination with either CT or MRI) is rarely indicated anymore. Bone scintigraphy is another imaging method with limited use in shoulder joint abnormalities (neoplasm, infection, occult fracture). Sonography is useful in abnormalities of the rotator cuff and the biceps tendon. This method is commonly employed for screening. CT is useful in the demonstration of complex fractures. CT arthrography is indicated in instability of the glenohumeral joint and is competing with MR arthrography. MRI and MR arthrography are the imaging method of choice for many indications, mainly due to their free choice of imaging planes and excellent contrast resolution. These methods provide the most detailed diagnosis mainly with regard to abnormalities of the rotator cuff (partial versus intact or full-thickness tears) and the biceps tendon and are useful in the assessment of instability.
肩关节的多种异常情况可导致疼痛或功能障碍。对这个复杂关节进行成像具有挑战性。标准X线片被认为是所有成像的基础。为了进行更详细的诊断，尤其是涉及软组织的诊断，需要更先进的成像方法。标准关节造影（不与CT或MRI联合）如今很少被采用。骨闪烁显像在肩关节异常（肿瘤、感染、隐匿性骨折）方面的应用有限。超声检查对于肩袖和肱二头肌肌腱的异常情况很有用。这种方法通常用于筛查。CT对复杂骨折的显示很有用。CT关节造影适用于盂肱关节不稳，且与磁共振关节造影相互竞争。MRI和磁共振关节造影是许多适应证的首选成像方法，主要是因为它们可以自由选择成像平面且具有出色的对比分辨率。这些方法主要针对肩袖（部分撕裂与完整或全层撕裂）和肱二头肌肌腱的异常提供最详细的诊断，并且在评估关节不稳方面很有用。
