Shoulder

Over the last 20 years the “forgotten” shoulder joint has attracted a lot of orthopaedic attention primarily focused on rotator cuff disease, instability and arthroplasty. New orthopaedic concepts and a better understanding of the relationship between shoulder structure and function have increased the role of, and demand for imaging of the shoulder. With this increased interest, an increased application of imaging methods has evolved to support diagnosis, therapeutic decision making and outcome assessment. Revisiting the conventional radiograph has led to the creation and harnessing of a number of measurements, whose values relate not only to structural relationships but more importantly to shoulder function. Increasingly, these values are sought for before arthroscopic procedures but also prior to carrying out a shoulder replacement, to optimise the choice and ensure accurate placement of the implanted prosthesis. Cross-sectional imaging (CT and MRI) has also been used to provide accurate measurement of important structures such as the glenoid and acromion, whose morphology is difficult to ascertain with conventional radiography. These techniques along with ultrasound also provide visualisation of the soft tissues of the shoulder, which are increasingly being employed in providing qualitative and quantitative values to aid clinical diagnosis and management.