Aug 11, 2026 · 18 min · 7 segments
In this module of In the Clinic, the team discusses Diana Neer, a 64-year-old woman complaining of shoulder pain. To claim your CPD credits, click the link below and then select "Complete Activity."…
Aimée BrzeskiHost
Jess KirkwoodHostJennifer YoungHost
So first of all, ultrasounds, not MRIs, should be ordered if rotator cuff tear is suspected.
It is as sensitive as MRIs for rotator cuff pathology, but it is more accessible.
Sorry, just wanted to, to dive in there that I think, then, so there is a Canadian Association of Radiology.
They have, uh, they have guidelines that are accessible for all of us who are in, called re- referral guidelines.
And, and this comes from their guideline, um, the, that ultrasound is the, is the, uh, which, which was it? When I looked up this, I thought, "Oh, that's, but that's interesting."
No, and, and, and you'll probably ha- You know, people will be thinking, "Well, but my orthopedic surgeon always, like, they insist on an MRI." You know, so it's, it, I think it does also depend on how much faith your orthopedic surgeon in the region has with the, yeah, with the ultrasound techs.
So first of all, ultrasound should be first line, and then second of all, it should really be reserved for cases only when surgical intervention is considered.
Uh, the reason being that asymptomatic tears are common, and they do not always correlate with function, and we'll get back to that, that in a second.
X-rays really can help diagnose osteoarthritis and may show some chronic changes in large rotator cuff tears, which are usually chronic with some humeral head migration.
So the X-rays are not that helpful either when you're suspecting, uh, rotator cuff pathology.
So first of all, ultrasounds, not MRIs, should be ordered if rotator cuff tear is suspected.
It is as sensitive as MRIs for rotator cuff pathology, but it is more accessible.
Sorry, just wanted to, to dive in there that I think, then, so there is a Canadian Association of Radiology.
They have, uh, they have guidelines that are accessible for all of us who are in, called re- referral guidelines.
And, and this comes from their guideline, um, the, that ultrasound is the, is the, uh, which, which was it? When I looked up this, I thought, "Oh, that's, but that's interesting."
No, and, and, and you'll probably ha- You know, people will be thinking, "Well, but my orthopedic surgeon always, like, they insist on an MRI." You know, so it's, it, I think it does also depend on how much faith your orthopedic surgeon in the region has with the, yeah, with the ultrasound techs.
So first of all, ultrasound should be first line, and then second of all, it should really be reserved for cases only when surgical intervention is considered.
Uh, the reason being that asymptomatic tears are common, and they do not always correlate with function, and we'll get back to that, that in a second.
X-rays really can help diagnose osteoarthritis and may show some chronic changes in large rotator cuff tears, which are usually chronic with some humeral head migration.
So the X-rays are not that helpful either when you're suspecting, uh, rotator cuff pathology.
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