Shoulder MRI Scan: Your Complete Guide

MRI stands for magnetic resonance imaging, and is a type of medical scanning technique. It gives your referring physician detailed insights into your internal body structures and anatomy, to check for any problems or assess what might be causing symptoms.

As the shoulder joint comprises bones, soft tissues like cartilage and ligaments, blood vessels, lymph nodes and muscles, an MRI exam is a key tool for identifying shoulder injuries, causes of shoulder pain, and help you get an accurate diagnosis to inform your treatment pathway.

The basics of magnetic resonance imaging (MRI) scans

Magnetic resonance imaging (MRI) of the shoulder uses strong magnetic fields and radio waves to create images of the shoulder joint and surrounding tissues.

There are different types of MRI scanner - some look like a cylindrical tunnel with a flat bed that moves in and out, while others have magnets above and below or on either side of you. These are called open MRI scanners and are recommended for claustrophobic patients or people with reduced mobility. MRI scans are fairly noisy, so you will likely be given headphones or earplugs to wear during your procedure.

The MRI room must be carefully designed as the magnetic field of the machine is always on. This means that metal objects must not be taken into the scanning room, and the radiographer, who operates the machine, will leave the scanning room while the imaging takes place. You might be asked to change into a hospital gown if there is metal on your clothing, and you're advised not to wear jewellery, watches, belts and underwired bras.

MRI scans are widely used as they are safe, pain-free, non-invasive, and don't use ionising radiation like a CT scan or X-ray scan does. However, due to the magnetic field, some medical devices are not compatible with MRI scanning, so a different type of scan may be recommended.

Why might you need an MRI of the shoulder?

Your doctor might recommend a shoulder MRI to investigate any of the following concerns:

Shoulder pain - pain in the shoulder could be a symptom of several medical conditions, including:
- Rotator cuff disorders or tears.
- Rotator cuff tendinopathy (longer-term tendon damage following overuse of the shoulder joint).
- degenerative joint disorders, including a labral tear or fraying.
- soft tissue damage.
- Bone fractures.
- Bursitis, which is an inflammation of fluid-filled sacs in the shoulder that lubricate the moving surfaces of the joint.
Shoulder instability - MR imaging can investigate glenoid labrum damage, which is the soft fibrous tissue rim that keeps the humeral head (ball of the joint) stable, and offers shock absorption. This can be caused by dislocation or subluxation (partial dislocation).
Stiffness or reduced mobility of the shoulder, which could be a sign of frozen shoulder.
Outcomes of shoulder surgery and any complications.
Pain, swelling, bleeding, which could be a sign of an infection.
Lumps and bumps, to find out if they could be tumours.

How long does a shoulder MRI take?

Typically, a shoulder MRI scan is completed in between 45 minutes to an hour.

Do I need a contrast injection for my shoulder MRI?

For assessment of rotator cuff tears, a contrast agent is not usually recommended. This is because the soft tissue definition of non-contrast MRI is high enough to visualise the rotator cuff tendons against the shoulder muscles.

Gadolinium contrast is special dye that helps define certain areas of your body in more detail. In rare cases, gadolinium can cause allergic reactions, so it is important to inform your doctor if you have experienced this before.

Sometimes, your doctor will recommend contrast material for your scan to highlight certain areas, tissues or blood vessels, or if there is a suspected tumour. Contrast agents are typically administered using an IV, but you may have a guided contrast injection with an X-ray or ultrasound scan to position the dye in the right place. Your referring physician will provide advice and guidance on this prior to your scan.

What does an MRI of the shoulder show?

An MRI scan provides grayscale images of the complex shoulder anatomy, which includes:

Bony components like the humeral head (ball of the glenohumeral joint, which is at the top of your arm bone) or the scapula (shoulder blade)
Rotator cuff tendons and muscles
The glenoid labrum which surrounds the shoulder cavity and covers the bony surface. MRI can show a labral tear.
Ligaments that stabilise the joint
Articular structures and some ligaments that tend to require contrast material
Biceps tendon, which has a common attachment to the labrum
Bursae, which are fluid-filled sacs that cushion the joint and provide a gliding surface for movement that reduces friction.

How long does it take to get MRI shoulder results back?

At Scan.com, you will receive a post-scan consultation call from a clinician as soon as your shoulder MRI results have been received from the scanning centre. This is usually within 7 working days but can depend on the site's turnaround times. You will receive your imaging report, patient-friendly interactive version, and digital access to your images after your post-scan call.

How much does it cost for a private shoulder MRI scan?

Shoulder MRI scans start at £295, but contrast material incurs an additional cost of £150, which is charged after your pre-scan consultation call.

Does your whole body go in for an upper arm or shoulder MRI?

A shoulder MRI is typically performed with the whole body inside a traditional MRI scanner, though your feet may remain outside the machine.

If you suffer from claustrophobia, you may be recommended an open MRI scanner, which lets you see the room around you more clearly. However, the magnetic field of an open scanner is lower than a traditional machine, so they are not suitable for all types of MR imaging.

Which is better - MRI, ultrasound, X-ray or CT scan - for shoulder?

MRI is the gold standard for shoulder imaging, and is typically performed for rotator cuff tears. While X-rays can show the shoulder joint and look for fractures or arthritis, they re not able to differentiate the soft tissues to identify tears, for example. Only a very large tear could be identified from an X-ray if it alters the alignment of the bones.

CT or computed tomography scans have lower contrast than an MRI scan, so the tendons and surrounding soft tissues tend to blend together. However, a CT scan may be recommended for imaging of a complex fracture.

Ultrasound can be used to identify tears but requires special training and may not be as effective for deep tears. However, ultrasound can be used dynamically while a joint is in motion, whereas in an MRI, X-ray or CT scan, the patient must lie completely still. Therefore if there is clicking, catching or grinding of the joint, an ultrasound may be recommended to identify the problem in motion.

How to read MRI shoulder results? The role of a radiologist

MRI produces images in black and white, with various levels of shading and contrast caused by different proton density weightings. A radiologist is a highly trained specialist doctor, who interprets MRI images and writes a report of their findings. A patient would never be expected to interpret their own images, as an expert level of anatomy knowledge is required to identify any abnormal results.

A radiologist will run through the hundreds of MRI images (slices) collected during your scan on a computer, and will scan back and forth in different areas to check for any pathology.

After they've reached their conclusion, they will create a report explaining what the results show. Here at Scan.com, we offer further information with an interactive patient-friendly report. It gives you clickable diagrams and definitions to help you confidently understand any medical jargon.

The bottom line

If you are experiencing shoulder pain, upper arm pain, limited movement, or have found a lump in the area, a shoulder MRI scan can help identify the source of the issue, and help you access treatment. The sooner an issue is found, the quicker the recovery time usually will be, and the less time you will need to spend in pain. Don't hesitate to book your shoulder MRI scan today.