Imaging Utilization Review

Case Summary

Requested Study(ies)

MRI Right Shoulder without contrastM75.100 - Rotator cuff syndrome
Requesting Provider:Dr. Ortho
Date Requested:05/12/2025

Clinical Information:

45-year-old male with persistent right shoulder pain for 3 months. Failed conservative management including physical therapy and NSAIDs. Positive impingement signs on exam. X-ray shows mild AC joint degeneration. Evaluate for rotator cuff tear and other soft tissue pathology.

Status:

Pending Review