In suspected rotator cuff tear, which imaging study provides definitive anatomic detail?

• A. MRI of the shoulder
• B. Ultrasound of the shoulder
• C. X-ray of the shoulder
• D. CT scan of the shoulder

Answer: (A)

Rotator cuff pathology is best evaluated with detailed soft-tissue imaging. MRI of the shoulder provides the most definitive anatomic detail because its high-resolution, multiplanar sequences clearly visualize all rotator cuff tendons, show whether a tear is partial- or full-thickness, define the size and retraction of the tear, and assess muscle quality including fatty atrophy. This level of information is essential for prognosis and surgical planning. While ultrasound can detect tears and is useful for dynamic assessment, it is operator-dependent and may miss subtle or partial-thickness tears. X-ray and CT excel at bone assessment but do not visualize the soft-tissue rotator cuff with the same detail as MRI.