Shoulder arthrography is an important investigative means in studying various softtissue lesions involving the shoulder. However, the accurate size and the area of the lesion are difficult to detect in arthrograms made with conventional screen-films. Since 1985, we have performed glenohumeral arthrography in combination with subacromial bursography on 50 patients with suspected rotator cuff tear, impingement syndrome and/or frozen shoulder, using computed radiography. In the normal shoulder arthrogram, the long head of the biceps is very well outlined and the surfaces of the rotator cuff are smooth and clearly delineated. In impingement syndrome, attritional changes are detected on the bursal surface of the rotator cuff at the critical zone without difficulty. In incomplete thickness tear, the bursal surface around the critical zone appears irregular and rough. Horizontal tear is also clearly visualized. In some cases of full thickness tear, the edge of the torn cuff is demonstrated.
Computed radiography provides much more detailed information about the pathology of the lesion than conventional arthrography, since both soft tissues and bone can be clearly demonstrated by simply changing the desired parameters. This technology permits the preoperative evaluation, not only of the presence of a rotator cuff tear, but also of the accurate extent of the lesion.
