What is the ideal imaging method to assess the shoulder prior to TSA?

The ideal imaging method to assess the shoulder prior to Total Shoulder Arthroplasty (TSA) is a CT scan or MRI. These modalities provide detailed images of the bone and soft tissue structures within the shoulder joint, allowing for a comprehensive evaluation of the anatomy and pathology present. A CT scan is particularly effective in assessing complex bone structures, such as the glenoid and humeral head, which are critical for planning the surgical approach and ensuring proper alignment and positioning of the prosthetic components. An MRI, on the other hand, excels in visualizing soft tissues, including the rotator cuff and cartilage, providing insight into any associated injuries or degenerative changes that may influence surgical decisions and outcomes.

In contrast, while X-rays can provide a good initial assessment of bone alignment and arthritis, they lack the detail required for a thorough preoperative evaluation, particularly when considering prosthetic placement and potential complications. Ultrasound, although useful in evaluating soft tissue conditions, cannot replace the comprehensive views offered by CT or MRI, especially in a surgical context. Blood tests do not provide imaging information and are not relevant for anatomical assessment in preparation for TSA.