What imaging modalities are recommended for confirming a diagnosis of rotator cuff injury in primary care?

In primary care, ultrasound is the recommended first-line imaging modality to confirm a diagnosis of rotator cuff injury. Ultrasound offers a cost-effective, accessible, and dynamic assessment of the rotator cuff tendons, allowing for real-time evaluation of tears and tendon pathology without radiation exposure ¹. It is particularly useful for detecting full-thickness and partial-thickness tears and can be performed promptly in the primary care setting (Lee et al., 2016). Magnetic resonance imaging (MRI) is generally reserved for cases where ultrasound findings are inconclusive, or when surgical planning is required, as it provides superior soft tissue contrast and detailed anatomical information (Toh, 2024). UK guidelines emphasize ultrasound as the initial imaging choice due to its practicality and diagnostic accuracy in primary care ¹, while recent literature supports this approach but also highlights MRI’s role as a complementary modality when further detail is necessary (Lansdown and Feeley, 2012; Toh, 2024).