Two-and three-dimensional imaging of the painful shoulder

Fifty-six patients with musculoskeletal disorders involving the shoulder were examined using two-dimensional computed tomography multiplanar reconstruction and volumetric three-dimensional (3D) image processing. Two- and three-dimensional imaging of the shoulder demonstrated advantages over conventional radiography in clarifying areas of complex anatomy. The techniques were found most beneficial for (1) delineating complex fractures; (2) evaluating joint instability; (3) localizing foreign bodies; (4) detecting lytic lesions; (5) assessing soft tissue pathology; and (6) identifying causes for decreased range of motion. Two-dimensional multiplanar reconstruction provided superior views of the scapula and permitted a better understanding of the orientation of the glenoid. Multiplanar reconstruction displayed deep soft tissue anatomy more clearly, including the course of important neurovascular structures. Volumetric 3D imaging added several unique perspectives, providing a more comprehensive representation of the shoulder and its articulating surfaces. The ability to rotate the shoulder about he vertical and horizontal axes in an animated video loop and to edit away confusing, overlying structures provided a "real-time" 3D model of the shoulder for planning treatment.