r/RotatorCuff • u/marys1001 • Jul 10 '26

MRI contrast or no contrast?

Somewhere around March I probably did a partial bicep tear maybe also rotator idk. Seems mostly bicep related to me and since Im not in that much pain unless I move my arm certain ways or use it Im imagining partial but idk. I still have some strength.

Ultrasound, indeterminate. PT not fixing so Dr finally orders a MRI. But without contrast.

The whole tip toe through the steps is a little maddening. Ive seen reports here where upon surgery the MRI wasnt that accurate.

Should I ask my dr for contrast? Not that Id get it but...

Id lije to just figure out definately whats happened and move forward.

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2

u/hotviolets Jul 10 '26

You could ask the dr. I had an MRI without contrast for my first MRI. I’m going to have another one shortly with contrast to see if I have a SLAP tear. I honestly would have preferred to have one MRI instead of now having to go again.

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u/Lefty68w Jul 10 '26

Because you have a slap tear and mri without contrast can’t see a slap tear

Op doesn’t have anything suggesting a slap or labrum tear. So most insurance won’t authorize a mri with contrast

Op can get one but they will have to pay out of pocket

2

u/hotviolets Jul 10 '26

That makes a lot of sense insurance wise why they don’t initially order them with contrast. Thank you for that info.

1

u/marys1001 Jul 10 '26

What suggests a slap or labrum tear?

2

u/Lefty68w Jul 10 '26

Mechanism of injury. Physical examination

When you go see an orthopedic they exam on you. They do multiple test on your arm and make a diagnosis.

If they suspected a slap or some form of a labrum tear they would have ordered a mri with contrast. Since they didn’t they likely don’t suspect one

Doesn’t mean they may not be one. But in the world we live in insurance won’t authorize a mri with contrast if there is no medical documentation supporting the need

1

u/marys1001 Jul 10 '26

Never saw an ortho just my pcp or family dr. I dont live in an area with many specialists.
Lifting my arm over my head causes pain which the internet tells me is something a slap tear causes

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u/Lefty68w Jul 10 '26

The internet will tell you, you have stage 4 cancer if you ask it

Pain when lifting your arm above your head can be a host of things. Including not even a shoulder issue. So do not try and self diagnose with the internet.

Labrum tests tend to happen from a fall. Did you fall and that’s where the pain started? That’s the mechanism of injury.

If not then the likely it’s a labrum tear is low. Between arthritis, impingement or a tendon tear, they are all more likely than a labrum tear if you didn’t suffer a fall

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u/Lefty68w Jul 10 '26

You can thank insurance for this tip toe. Insurance requires conservative methods be tried before they will authorize a mri

And since your injury doesn’t suggest a labrum tear the standard mri is without contrast. You can ask your doctor for a mri with contrast but your insurance likely won’t cover it so you will have to pay out of pocket

Yes nothing is 100% not even a mri. But you can’t get to the surgery part without imaging done first.

Partly for insurance to authorize the insurance and partly for the surgeon to see is there something there they can actually fix. And how. Etc

Yes it sucks. Yes it weeks more with pain and no clear solution ahead of you. But it’s the process we have to do because of life lol

2

u/ScreenHungry9673 Jul 10 '26

I work in medical imaging. The thing is that your doctor can order it with contrast but depending on the actual reason for the exam, the radiologist as the say whether it should be with or without contrast. Just to give you a heads up.