Shoulder Instability: Investigating the problem

Physical examination

Mr. Cole will talk to you about your shoulder symptoms and your shoulder’s history. He will examine your shoulder and assess your range of movement. He will put you arm in certain positions and will perform the clinical instability tests. This normally provides sufficient evidence for a diagnosis to be made. However, he may wish to see an x-ray or an MRI Arthrogram scan of the damaged shoulder.

X-ray

An x-ray can provide an excellent ‘picture’ of bones and joints and will clearly show any dislocation or subluxation. It may show previous damage to the bone suggestive of previous dislocations or subluxations such as a Hill Sachs lesion (a ‘dent’ in the head of the humerus)

MRI Arthrogram

Especially in cases of traumatic instability, there may be some damage to the shoulder’s rim of cartilage, ligaments, tendons and muscles. An MRI can highlight any damaged areas.

MRI stands for Magnetic Resonance Imaging. It uses a powerful magnet to obtain three dimensional pictures of body structures. In cases of instability the accuracy of the investigation is significantly improved with an injection of gadolinium into the joint (Arthrogram).