MRI, CT, Scintigraphy and Arthroscopy

Nowadays this method is used for diagnosis of partial and complete ruptures of a muscle, at synovitis of joints, a damage of the subchondral bone and ruptures of labrum glenoidale. MRI is a perfect method for diagnostics of pathology of the rotator cuff. MRI is also suitable for examination of osteonekrosis (with nearly the same specifity as scintigraphy) or tumorous tissue. Unfortunately this method is worse accessible, economically and time-consuming, and especially it is not possible to make performances as artrocentesis under the visual checking. Another essential disadvantage is an impossibility to make MRI at patients who have magnetic metal in their body. Because of a frequent occurrence of alloplasties at our patients it is not possible to be done.

At present this method is very common and useful for examining of some pathological states. The tomographic examination is often made in a combination with arthrography as ArthroCT which has become the main diagnostic method at lesions of labrum glenoidale, at looking for foreign bodies and chrondral lesions. The main indications of ArthroCT are traumas of the glenohumeral articulation where we suppose ruptures of labrum glenoidale and osseous pathology.

In our opinion, in the case of pains of the shoulder girdle, this method is quite old, and it can be replaced by other examining methods with a bigger telling ability.

Diagnostic arthroscopy, nowadays also connected with arthroscopic operative technique, is recommended for the examination of synovitis of the glenohumeral joint, a damage of the cartilage, a presence of foreign bodies, and partly also a damage of  labrum glenoidale. We think this method will a greater meaning in future than nowadays. On condition that patients will be sent to this  technique after previous MRI or ultrasound examinations. Its meaning is mainly diagnostic because it facilitates a sampling of tissues for a final diagnosis. A problem is still small accessibility of departments of arthroscopy, and present joining of this technique to the orthopeadic branches. It means that most of the affections of the shoulder girdle are simplified on the dg. of impigiment or traumatic affections. Arthroscopic examination represents an ideal only after carrying out the ultrasound or MRI examination, and respecting of conclusions of these methods.