Mra w/ contrast or mri without for a 14 yr old tennis player with moderate to severe shoulder pain? had pt 4 mo, but worse. labral tear mentioned.

MRI: MRI is study of choice for structure of shoulder components.

Depends: Labral tears can be better seen with MR arthrogram, though good MRI machines/ radiologists can often detect them with routine MRI images. Talk to your doc about which testing is better in your area/ facility to suit your needs

MRA with contrast: An MRI arthrogram is more accurate in this situation. It is much more sensitive for picking up labral tears and other irregularities that would not show nearly as well or with as much detail as a regular MRI without contrast. The downside of having to do an intraarticular injection is justified because of the increased accuracy for diagnosing label tears in this population.

MR with Arthrogram: The best study is an MRI study with and without an arthrogram. I do thousands of these studies each year, and tears are routinely missed or over diagnosed in studies without an arthrogram component. A pre arthrogram component helps to identify areas of inflammation which are masked by MRI performed with only an arthrogram, such as synovitis and bursitis. Google "Dr Nefcy" for more information.