The first examination is plain films of the shoulder. Films of the cervical spine should also be considered since shoulder pain is often radicular pain. MRI of the shoulder without contrast should be reserved for clear evidence of rotator cuff injury or other clinical applications that require advanced imaging. When deciding whether or not to employ advanced imaging applications please consider whether or not the patient is a potential surgical candidate. If subsequent surgical intervention is not feasible there may be no need to proceed with further imaging evaluation. CT is rarely used except for fracture or contrasted arthrography.