Double-contrast computed tomography of the shoulder

As a modality for the study of abnormalities of the shoulder, double-contrast computed tomography (CT) is accurate, is relatively easy to perform, and requires only a low dose of radiation. The results can be extremely helpful in preoperative planning. In this study, CT images were obtained for 247 patients who had undergone routine double-contrast shoulder arthrography. Abnormalities shown on CT images included glenoid labrum attenuation and tears, glenoid fractures, loose joint bodies, intracapsular staples, intra-articular screws, adhesive capsulitis, rotator cuff tears, peritendinitis calcarea, biceps tendon tears, and capsular abnormalities. In the 41 cases in which surgical correlation was available, all of the confirmed abnormalities had been identified on double-contrast CT images. Of the patients with rotator cuff tears, 80% had other abnormalities of the shoulder, and 48% had glenoid labrum tears. Of the patients with peritendinitis calcarea, 40% had glenoid labrum tears, and 33% had rotator cuff tears. Double-contrast CT studies of the shoulder are recommended when patients experience a decrease in range of motion, persistent shoulder pain, or signs of instability. Frequently, patients with rotator cuff tears and peritendinitis calcarea have coexisting abnormalities.