ACR Appropriateness Criteria^® Shoulder Pain-Traumatic

Area of Science:

• Orthopedics
• Radiology
• Sports Medicine

Background:

• Traumatic shoulder pain results from acute or chronic injuries like fractures or soft-tissue damage.
• Common injuries include clavicle, scapula, proximal humerus fractures, and rotator cuff, AC ligament, or labroligamentous complex tears.

Purpose of the Study:

• To outline imaging assessment strategies for traumatic shoulder pain.
• To detail the roles of various imaging modalities in diagnosing shoulder injuries.

Main Methods:

• Conventional radiography as the initial imaging step.
• MRI/MR arthrography for soft-tissue injuries, CT for fractures.
• Ultrasound for rotator cuff assessment, CT angiography/arteriography for vascular injury.
• Bone scintigraphy for complex regional pain syndrome.

Main Results:

• Radiography is the first-line imaging for traumatic shoulder pain.
• Advanced imaging like MRI, CT, and ultrasound are selected based on clinical findings and suspected injury type.
• Specific modalities are best suited for different injuries: CT for fractures, MRI for soft tissues, ultrasound for rotator cuff.

Conclusions:

• A systematic approach to imaging is crucial for diagnosing traumatic shoulder pain.
• The choice of imaging modality depends on the suspected diagnosis, guiding effective treatment.
• The American College of Radiology Appropriateness Criteria provide evidence-based guidelines for these imaging decisions.