MRI or Arthro-MRI are not systematic. Standard X-rays often provide sufficient information to establish an accurate diagnosis. In our experience, ultrasound is very rarely requested. We prefer printed imaging rather than CD-based imaging, which can sometimes be impossible to read depending on the software used.

– Pain localised on the lateral side of the arm

This is likely a rotator cuff tendon injury. It may extend towards the neck and chest, suggesting a shoulder calcification. It may also be associated with pain on the anterior side of the arm, indicating inflammation or an associated injury of the long head of the biceps tendon.

– In all cases, we request an AP X-ray of the shoulder in neutral rotation and a lateral outlet view

• The AP X-ray reveals a shoulder calcification. The precise diagnosis of the cause of pain is established. Any additional imaging (MRI, ultrasound) is unnecessary.

• The lateral outlet view reveals an aggressive anterior acromion that can cause damage to the rotator cuff tendons and the long head of the biceps tendon. In this case, Arthro-MRI (MRI with contrast injection) is necessary. This specific examination will reveal the condition of the cuff tendons: simple wear caused by the acromial bony spur, or a true tendon tear. Arthro-MRI is more precise than standard MRI. If the patient is claustrophobic, Arthro-CT scan can replace Arthro-MRI.