Radiologic Testing
Once the physical examination is complete, the third step in diagnosing shoulder pain is ordering the right diagnostic tests. All too often, testing is treated as the first step instead. Many people believe an MRI is the surest way to find out why a shoulder hurts — yet that assumption can result in surgeries that were never needed.
Types of Radiologic Testing for Shoulder Pain
X-Rays: An X-ray is typically the first test ordered. It is often the best study for arthritis and bone spurs, and for ruling out fractures or calcific deposits. Ultrasound: High-frequency sound waves allow a quick look at the rotator cuff and biceps tendons. MRI: Used to confirm a suspected diagnosis, gauge how severe it is, or rule out other possibilities.
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Imaging is most useful when it follows a careful history and physical exam, not when it replaces them. Each test — X-ray, ultrasound, or MRI — answers a different question about the shoulder, so the right choice depends on what the examination suggests. That sequence helps confirm a diagnosis and avoid unnecessary procedures.