Diagnosis of a capsule rupture in the shoulder

In order to diagnose a capsule tear in the shoulder, the first step is a thorough physical examination of the joint by the doctor and a targeted discussion with the patient regarding the cause of the injury and the symptoms. Questions about the patient’s medical history are also relevant. Previous injuries to the shoulder, such as dislocation of the arm or the presence of disease, as well as the taking of medication, can be of great importance.

Through the examination, the doctor can determine the stability and the active and passive range of motion of the shoulder. If the results of the examination lead to the suspicion that the capsule or the ligamentous apparatus of the joint may have been injured, the doctor will initiate further examinations. A simple x-ray usually only serves to detect or exclude bony injuries.

An ultrasound examination may be more likely to provide information as to whether or not the capsule could be injured. The best method of imaging a capsule tear is MRI (magnetic resonance imaging). Magnetic resonance imaging is the best method for detecting a possible capsule rupture in the shoulder.

However, the examination is costly and time-consuming and should therefore only be performed if there is a well-founded suspicion and if the examination result is associated with a consequence for the patient. The decision to perform an MRI should therefore be based on a targeted medical discussion with the patient and a thorough physical examination of the shoulder. If this should lead to the suspicion of a capsule tear in the shoulder and this is confirmed by the MRI, a decision can be made as to whether or not surgery is necessary from a medical point of view. Unlike CT (computed tomography), MRI is not associated with radiation exposure. However, the examination must not be carried out if there is metal in the body, such as with a pacemaker or bone screws after an accident.