MRI of the shoulder is considered the gold standard for evaluating soft tissue structures like the rotator cuff, labrum, and ligaments. It provides detailed anatomical information and high accuracy in diagnosing tears, tendinopathy, and other soft tissue pathologies. While ultrasound can be used as an initial screening tool, its accuracy is highly operator-dependent. Plain X-rays are useful for bony pathology (e.g., fractures, arthritis) but not for soft tissue tears. CT arthrography is an invasive procedure that involves injecting contrast into the joint and is less commonly used than MRI for this indication.
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