Understanding Shoulder X-rays and MRIs
Sports-related problems of the shoulder fall under two categories: those problems relating directly to bones (scapula, clavicle, or humerus), and those problems relating more to the shoulder's soft tissue structures (ligaments, tendons, muscles, rotator cuff, joint bursa, capsule, or glenoid labrum). Often your physician will need x-rays and possibly an MRI of your shoulder to adequately diagnose your specific problem. This web section will assist you in your understanding of these common radiological studies.

X-rays are key to your evaluation and may reveal bone dislocations, malalignments, fractures, and other changes to the bone tissue. Often x-rays are used to rule out a fracture problem; if the bone appears normal, then the focus can be shifted to other areas of concern. In the x-rays below, the bone structures are white or light gray in tone, and the soft tissue surrounding the bone remains dark. Simply put, only the hard, dense bones "show up" in an x-ray, and the other structures such as nerves, muscles, tendons, or rotator cuff are not usually seen.
Normal x-ray of the shoulder joint showing the clavicle, or collar bone, as it articulates with both the acromion of the scapula and the sternum. Normal x-ray of the shoulder joint demonstrating the relationship of the head of the humerus with the glenoid fossa.
Magnetic Resonance Imaging (MRI) is another type of non-invasive study that may assist your sports medicine physician in your diagnosis. The MRI will need to be performed at one of the local area hospitals or other MRI diagnostic center. The MRI images produced by this study are compiled onto one large film and visually represent thin sections or "slices" through a patient's shoulder. Unlike a conventional x-ray image that represents an entire anatomical area, the MRI shows thin layers or cross-sections.
MRI of the shoulder joint showing a rotator cuff tear (arrow). The tendinous "cuff" is torn resulting in a gap (dark space) in the cuff near its insertion or attachment onto the head of the humerus. MRI of the shoulder revealing an enlarged acromio-clavicular joint (arrow). This joint has become enlarged or hypertrophied because of the changes to the bones at the AC joint. If the over-growth continues, it may impinge upon the head of the humerus.