Diagnostic Imaging for Rotator Cuff Pathology

Imaging Modalities

• The American College of Radiology recommends MRI without contrast as the gold standard imaging modality for confirming rotator cuff pathology, with a rating of 9/9 for appropriateness 1
• Ultrasound is equally appropriate, with a rating of 9/9, for evaluating rotator cuff integrity when performed by experienced operators 1
• MRI can provide additional important information about tendon retraction, muscle atrophy, and fatty infiltration that guides treatment decisions, according to the American College of Radiology 2

Treatment Planning

• Positive empty can and drop arm tests warrant further investigation with imaging to confirm diagnosis and determine the extent of the tear, as recommended by the American College of Radiology 1
• Imaging findings help determine whether conservative management or surgical intervention is appropriate, based on guidelines from the American College of Radiology 2