Sports medicine orthopedists at NYU Langone Orthopedic Center collaborate with orthopedic radiologists to determine the type, severity, and location of shoulder sprains, strains, and tears. These injuries occur when parts of the shoulder are stretched or torn.
Three bones come together to form the shoulder joint: the clavicle, or collarbone; the humerus, or arm bone; and the scapula, or shoulder blade. They are held in place by muscles, ligaments, and tendons. Ligaments are strong, flexible tissues that connect bone to bone. Tendons attach muscle to bone. The top of the humerus rests in a shallow socket, or cavity, called the glenoid, and is stabilized by a ring of cartilage called the labrum.
Sprains, strains, and tears can affect the shoulder’s ligaments, muscles, tendons, or labrum.
NYU Langone doctors rely on details about your symptoms and lifestyle to diagnose a shoulder injury. They need to know where you feel pain and whether it’s consistent or intermittent or gets worse during arm movement. Your doctor asks whether you experience any weakness or limited movement. Doctors also want to know if you have had a dislocated shoulder or shoulder surgery in the past.
Shoulder injuries often occur suddenly, so your doctor may ask if you can recall an incident that led to shoulder pain, weakness, or dislocation. For example, if you use your arm to break a fall, your shoulder absorbs the impact, and the soft tissues surrounding the joint may be damaged.
Doctors may also ask about your daily activities for additional clues about the cause and nature of your injury. Jobs that require you to repeatedly lift your arms, such as house painting or hairstyling, may stress the soft tissues in the shoulder. If you’re an athlete, years of overhead motions may gradually wear down the soft tissues in the shoulder. At some point, a movement may cause them to become sprained, strained, or torn.
Your NYU Langone doctor conducts a thorough physical exam to evaluate your shoulder’s range of motion and strength. He or she also assesses your level of discomfort while you move.
The doctor may gently manipulate your arm to determine if there are any visible signs of a torn tendon, ligament, or labrum. For example, a severely torn biceps tendon often causes the muscle to bulge out of place when contracted.
X-rays use high-energy beams of light to create pictures of the body. Doctors use X-rays of the shoulder to examine the bones and determine if any bone spurs are present or if there is a fracture, which can cause similar symptoms. X-rays can also help doctors rule out osteoarthritis of the shoulder as the cause of your symptoms.
Ultrasound uses high-frequency sound waves to view structures inside the body. Doctors may use an ultrasound to reveal tears in tendons or impingement, which is when a tendon gets caught under the shoulder blade during movement of the arm.
Ultrasound may also help doctors determine if you need further diagnostic imaging tests, such as MRI, which can provide a clearer view of the soft tissues.
MRI scans use a powerful magnetic field and radio waves to create images of soft tissues inside the body. This imaging test is especially helpful to doctors when diagnosing a shoulder tear because MRI scans can reveal subtle damage to tendons in the rotator cuff and biceps. These scans also enable doctors to determine whether a tear is partial or complete and to confirm the exact location of a tear in the labrum.
If a shoulder tear occurred long ago and has limited your ability to move your arm, MRI helps doctors to see if muscles surrounding the shoulder joint have been weakened or damaged as a result.
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