American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the preferred imaging modality for diagnosing a full-thickness rotator cuff tear?

1. X-ray

2. MRI

3. Ultrasound

4. CT scan

The correct answer is: MRI

The preferred imaging modality for diagnosing a full-thickness rotator cuff tear is MRI. This advanced imaging technique provides detailed views of soft tissues, including muscles, tendons, and cartilage, making it particularly effective for assessing the rotator cuff. MRI is non-invasive and does not involve radiation, which is an important consideration for many patients. MRI allows for the visualization of not only the tear itself but also any associated changes in the surrounding structures, such as inflammation or muscle atrophy. Furthermore, it can help in differentiating between partial and full-thickness tears, which is crucial for determining the appropriate management and treatment plan. While ultrasound can also be useful in diagnosing rotator cuff injuries, MRI tends to be more definitive, particularly in complex cases. Other imaging modalities, such as X-rays, are primarily used to rule out bony abnormalities or fractures rather than to diagnose soft tissue injuries like rotator cuff tears. CT scans can be beneficial for evaluating bony structures and certain complex shoulder issues but are not typically the first choice for assessing soft tissue injuries such as rotator cuff tears.