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MRI shoulder is the modality of choice for detailed assessment of intra-articular and peri-articular structures of the shoulder joint. It provides excellent soft tissue contrast and multiplanar capability, making it invaluable for evaluating rotator cuff, labrum, cartilage, and marrow abnormalities.

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Anatomy on MRI

Key structures assessed:

• Bones: humeral head, glenoid, clavicle, scapula, acromion.
• Articular cartilage of humeral head and glenoid.
• Labrum: fibrocartilaginous rim around glenoid.
• Capsule & ligaments: glenohumeral, coracohumeral, coracoacromial ligaments.
• Rotator cuff muscles/tendons: supraspinatus, infraspinatus, teres minor, subscapularis.
• Biceps tendon (long head).
• Subacromial–subdeltoid bursa.

MRI Protocol

• Planes: axial, coronal oblique (along supraspinatus), sagittal oblique.

Sequences:

• T1W – anatomy, marrow infiltration.
• PD/T2 fat-sat – fluid-sensitive (tears, edema, bursitis).
• Gradient echo – cartilage, loose bodies.
• MR arthrography (direct intra-articular gadolinium or indirect) – best for labrum, capsular ligaments.

Common Pathologies