What other imaging is needed in shoulder instability?

In this video, Dr. Grant H. Garcia discusses the advanced imaging options used to properly evaluate a patient suffering from shoulder instability.

Here is a summary of the key diagnostic steps he outlines:

• Initial Advanced Imaging (The MRI): For a patient who has experienced one or two shoulder dislocations, an MRI is typically the next step. Dr. Garcia notes that he is a big proponent of an MRI with intra-articular contrast (injecting dye directly into the joint space). While some studies suggest standard MRIs are sufficient, he finds that contrast makes it significantly easier to clearly spot labral tears.
• Determining Dislocation Direction: Advanced imaging helps the surgeon accurately evaluate whether the shoulder popped out through the front or the back, which can sometimes be difficult for the patient to know for sure based on memory alone.
• Evaluating Bone Loss: The imaging is crucial for assessing potential structural bone damage or wearing down of the joint.
• When a CT Scan is Necessary: If a patient has a more severe or chronic history—such as five, six, or seven dislocations—or if the initial MRI reveals concerning bone abnormalities, a CT scan is ordered. Dr. Garcia explains that a CT scan is the best way to accurately observe bony issues, such as a shortened or worn-down socket wall or a large dent in the bone.