Diagnosis
Magnetic resonance imaging is mainly used when injuries of the soft tissues and/or tendons are suspected. Usually, MRI of the shoulder joint reveals tears or ruptures of the tendons in the rotator cuff or the long biceps tendon. In addition, it is possible to detect or rule out possible bursitis (inflammation of the bursa).
If a tumor of the soft tissues of the shoulder is suspected, an MRI is also used for diagnosis, since it cannot be seen in X-rays, ultrasound (sonography) or CT (computed tomography). MRI can also be helpful in the diagnosis of a fracture, a change in the joint or an infection of the joint. However, it is always important for the diagnosis that, in addition to magnetic resonance imaging, all other examination methods such as CT, ultrasound and X-rays and a good anamnesis are carried out.
Indications for MRI of the shoulder joint
The indications for an MRI examination of the shoulder include diseases of the muscle-tendon apparatus as well as events in the joint itself and the surrounding soft tissue. Although it is also possible to assess fractures in the bones involved in the shoulder joint (humerus, scapula, clavicle), CT or conventional x-rays are more suitable for this purpose due to the better imaging of bone structures. One possible indication for MRI imaging of the shoulder is inflammatory processes in the shoulder joint itself, which can have a variety of causes (e.g. infections, autoimmune diseases such as rheumatoid arthritis, metabolic diseases such as gout, or activated arthrosis in the sense of joint degeneration).
In the same way, inflammation of the bursae surrounding the shoulder joint (bursitis) can also be shown. Another indication is lesions of the muscle-tendon apparatus of the shoulder joint: these include diseases of the rotator cuff (e.g. tears in one or more tendons of the four shoulder muscles) and the so-called SLAP lesion (tear of the biceps tendon anchor), also known as glenohumeral instability (injury to the cartilage lip at the upper edge of the glenoid cavity, where the long biseps tendon originates). In addition, clinically determined shoulder instability is a possible indication for an MRI.
The instability can be traumatic (e.g. caused by an accident), microtraumatic (micro-injuries caused by permanent overloading) or atraumatic (e.g. due to a congenital joint capsule that is too wide), but also a recurrent instability of the shoulder joint after surgery in this area can justify MRI imaging. In addition, injuries in the acromioclavicular joint (ACG; joint between collarbone and shoulder) indicate an MRI examination.
This includes, in particular, ACG bursting, a lesion in the ligamentous apparatus of this joint. In addition to these musculo-skeletal diseases of the shoulder, the diagnosis of tumorous events in the shoulder region is also considered a possible indication for an MRI of the shoulder joint. The cost of an MRI examination of the shoulder differs slightly between a private patient and a public health insurance patient.
The reason for this is that the former are reimbursed according to the Gebührenverordnung für Ärzte (GÖA) and the latter according to the Einheitlicher Bewertungsmaßstab (EBM). The reimbursement rates are lower for SHI patients than for private patients, which is intended to keep health care costs as low as possible. The basic price for a pure MRI examination of the shoulder joint is at least 139.89€ for private patients and self-pay patients and at least 124.60€ for patients with health insurance.Additional costs can be added to these basic amounts, depending on whether additional images in special joint positions are required for special problems or contrast media are used. As a general rule, the costs of an MRI examination of the shoulder joint are only covered by health insurance companies if there is a reason or indication for doing so. Patients who request an MRI examination for their own reasons, without a medical necessity, are generally not reimbursed.
