Superior soft tissue contrast with MR imaging

44 year-old lady complained of inability to abduct her right shoulder.

MRI of the shoulder done showed selective atrophy of the supraspinatus and infraspinatus muscle along with areas of fatty replacement and mild oedema within.

These findings are in keeping with supraclavicular neuropathy.

The role of MRI in this instance is to detect any evidence of nerve compression along its route, particularly in the spinogenoid fossa. A gangion cyst in the fossa or a paralabral cyst may impinge upon the nerve as it runs through the fossa.

The spinoglenoid fossa in this patient was clear and there was no other detectable compressive lesion.

This case illustrates the usefulness of MRI in detecting soft tissue abnormality, e.g. muscle atrophy, muscle oedema or tendon injuries. MRI boasts with superior contrast sensitivity that negate the use of contrast in most cases, save for in patients where tumour or infection is suspected.