What is the Best Scan for Shoulder Pain?

Key takeaways:

• Shoulder pain can occur suddenly after an accident or slowly and gradually worsen from wear and tear or overuse. 

• The shoulder joint is complex, composed of bones, muscles, ligaments, tendons and cartilage, and as such, it can be difficult to pinpoint the exact cause of shoulder pain. 

• Diagnostic scans, including X-rays, MRIs, ultrasounds and CT scans, can be used to identify the cause of shoulder pain and help doctors create the right treatment plan. 

• The best scan for shoulder pain depends on your symptoms, when they started and how they started. 

• Private shoulder scans provide answers fast, allowing you to start treatment sooner. 

Pain in the shoulder can be caused by various conditions, including a frozen shoulder, tendonitis, stretched or torn ligaments, impingement, fractures, and dislocations.

Shoulder problems are common among people who regularly lift their arms above their heads for work or sports, such as decorators, painters, plasterers and racquet sports players. The shoulders can also be injured during accidents, such as motorbike accidents. 

Diagnostic scans of the shoulder provide detailed insight into the joint, highlighting potential causes of symptoms. 

When Do You Need a Scan for Shoulder Pain?

Shoulder pain can prevent you from exercising and playing sports. But it can also interfere with your daily life, making it difficult to carry out everyday tasks such as shopping, driving and lifting. It may even stop you from working. 

Understanding what’s causing your pain and discomfort is therefore important. Shoulder pain can be complex, and treatments vary. Getting a diagnosis means you can start the most appropriate treatment. 

Shoulder problems can develop gradually due to overuse or general wear-and-tear, or they may occur immediately following an accident or injury, and include:

• A persistent dull ache that may extend to the upper arm

• A sharp, stabbing pain

• Muscle spasms

• Stiffness

• Swelling

• Restricted movement, such as when trying to lift your arm above your head or move it behind your back

• Feeling like the shoulder is slipping out of place 

• Numbness or tingling 

• Redness and heat

• Clicking, pulling or a locking sensation

• Pain even when at rest or during the night 

Diagnostic scans provide clarity on what’s causing your symptoms. If you’re experiencing any of these shoulder symptoms, and they haven’t eased after two weeks of rest and over-the-counter painkillers, having a scan is an important step towards getting treatment. 

If you have severe or crushing shoulder pain or a feeling of pressure in the shoulder that develops suddenly and extends to your chest, neck, or jaw, call 999 and get medical attention immediately. This could be a sign of a heart attack. 

How is Shoulder Pain Diagnosed?

If you’re experiencing pain, stiffness or swelling in your shoulder that isn’t getting better, your doctor or specialist will go through a series of investigations to discover what’s causing your symptoms, make a diagnosis and suggest treatment options. 

1. Physical Examination: After asking some questions about your symptoms and when they started, your doctor will perform some initial assessments of your shoulder joint. This will involve a range of motion test, where they ask you to lift and rotate your arm at the shoulder joint and reach behind your back. As you do, they’ll be looking for weakness and assessing your discomfort, but they won't ask you to push yourself so far that it causes severe pain. They may also perform specific movement tests that may indicate that certain tendons or ligaments are damaged. 

2. Possible blood tests: Not all shoulder injuries warrant having a blood test, but you may have one, depending on your symptoms. Common blood tests for shoulder pain include an ESR (erythrocyte sedimentation rate), a CRP (C-reactive protein) and a rheumatoid factor (RF), which check for inflammation that could suggest rheumatoid or inflammatory arthritis. 

3. Medical Imaging Scans: Diagnostic scans give doctors a detailed look inside the shoulder joint, detailing the bones, soft tissues, nerves and blood vessels. Scan images will highlight fractures, dislocations, swelling, soft tissue injury, nerve damage and blood supply problems. 

4. Joint Aspiration: If you have painful swelling in your shoulder, you may have a minimally invasive procedure called a joint aspiration. During this procedure, your doctor will numb the area with a local anaesthetic, then use a long, thin needle to remove excess fluid and reduce swelling. This procedure serves two purposes; once the fluid is removed, the swelling should start to subside, and a sample of the fluid is sent to a laboratory to check for signs of inflammation, infection and bleeding. 

5. Diagnostic Arthroscopy: An arthroscopy is a type of keyhole surgery normally used to remove loose pieces of cartilage and other tissue that may be causing issues in the shoulder joint, or to repair joint damage, such as a rotator cuff repair. However, if your shoulder pain is proving difficult to diagnose, your doctor may carry out a diagnostic arthroscopy and use keyhole cameras to look deep into the shoulder joint. 

You may not have all of these tests and diagnostic procedures; sometimes, a scan is enough to diagnose a shoulder condition. 

Types of Scans for Shoulder Pain

A diagnostic scan of the shoulder is a quick, painless way to get answers without undergoing multiple tests and appointments. Shoulder scans provide doctors and musculoskeletal specialists, such as physiotherapists, osteopaths and chiropractors, with a detailed view of the shoulder joint from the inside. 

Once you have a diagnosis, your medical team will advise you on your next course of action. This is usually either rest, anti-inflammatory medication, physiotherapy, surgery or a combination of two or more of these. 

There are several types of shoulder scans, and which one you have will depend on your symptoms. 

X-ray

X-rays are often the first scan used to analyse shoulder pain. They show each bone of the shoulder joint, including the collarbone and the upper arm bones, highlighting any fractures or dislocations. They may also show abnormalities in the alignment of the shoulder joint. 

MRI Scan

MRI (magnetic resonance imaging) scans are the gold standard for diagnosing the cause of pain and discomfort and for detecting shoulder conditions. They produce detailed images of the bones, muscles, tendons and ligaments, and also show the nerves and blood vessels.

While X-ray images show fractures and dislocations, MRI scans show soft tissue injuries, tears, strains and sprains, as well as bone fractures and dislocations. 

MRI scans don’t use radiation, but they can be slow, taking an hour or more. They use radio waves and a strong magnetic field to create images. Due to the strong magnets used, they're not suitable for patients with magnetic metal inside their bodies. This includes certain types of cochlear implants, pacemakers, stents, meshes, clips and screws. 

An MRI scanner is a large, doughnut-shaped machine that makes a loud, knocking sound during a scan, so MRIs may not be suitable for patients with claustrophobia. Patients are also required to remain still throughout an MRI scan, which may therefore be difficult for those who struggle to stay still. 

Ultrasound

Ultrasound scans use high-frequency radio waves to produce dynamic, real-time images of the structures within the shoulder joint. Quick and non-invasive, they allow doctors to assess how well the shoulder moves in each direction and can detect problems caused by soft tissues catching on the bones during movement. Ultrasound scans can also be used to diagnose inflammation, swelling and cysts. 

CT Scan

CT (computed tomography) scans use low-dose X-rays to create highly detailed cross-sectional, three-dimensional images of the inside of the body. They’re used to provide detail on the health of the bones, soft tissues, nerves and blood vessels. 

When used to analyse the shoulder joint, CT scans are most common in emergency situations to assess trauma following an accident, such as a motorcycle accident. They’re useful for assessing complex fractures and for assisting orthopaedic surgeons during complex shoulder surgery, guiding them to specific areas. 

CT scans are quick, but as they use radiation, they’re only used when necessary, and not usually as a first-line scan. However, they can be used when an MRI isn’t suitable due to claustrophobia or the presence of metallic implants.

A CT scanner is smaller and less daunting than an MRI scanner. During a shoulder CT scan, patients generally lie on a bed while the scanner moves around the shoulder, rather than entering a machine. 

PET and Bone Scans 

PET (positron emission tomography) and bone scans are both nuclear medicine scans used to detect tumours affecting the bones and soft tissues. A radioactive tracer is injected into a vein, usually in the arm, that emits gamma rays. These rays are then detected by specialised cameras used in nuclear medicine scans to diagnose cancers. 

They’re not used in early investigations into shoulder pain because they’re so specialised, and are generally only used when other shoulder conditions have been ruled out, and other diagnostic scans have proved inconclusive. 

Which Scan is Best?

An MRI of the shoulder is considered the gold standard for diagnosing a range of conditions that can affect different parts of the joint. If you’re unsure which scan you need, an MRI will be most beneficial.

MRI scans visualise the soft tissues (including the muscles, tendons and ligaments) and cartilage and help diagnose conditions such as rotator cuff tears, damaged or worn cartilage and SLAP tears (a Superior Labrum, Anterior to Posterior tear of the labrum, the ring of cartilage in the shoulder socket). MRIs are routinely used to investigate sports injuries. 

X-rays are best suited for diagnosing bone fractures and dislocations, while ultrasound is helpful for capturing dynamic images of the joint to diagnose cysts, bursitis and soft-tissue injuries.

CT scans are quick and most commonly used in emergency situations to assess complex fractures and guide surgical procedures. 

Get a Scan

If shoulder pain is interfering with your quality of life and ability to do the things you enjoy, a private scan will give you answers, fast. Private shoulder scans are usually available within a week, and you’ll have your results in days. 

There’s no need for a doctor’s referral, and our team check each booking to ensure it’s the right one for you. Once you have your results. You can choose to have a consultation with us, or take your scan images and the consultant radiologist’s report to your NHS GP or musculoskeletal specialist.

References 

Website, N. (2026, April 15). Shoulder pain. nhs.uk. https://www.nhs.uk/symptoms/shoulder-pain/

Radiopaedia.org. (n.d.). Radiopaedia. https://radiopaedia.org/articles/shoulder-series?lang=gb

Ramsay Health Care UK. (1 C.E., January 1). How Can I Tell if Shoulder Pain is Serious? https://www.ramsayhealth.co.uk/blog/orthopaedics/how-can-i-tell-if-shoulder-pain-is-serious