Final answer:
An X-ray should be the first imaging test for a 13-year-old with shoulder pain after overhead throws to assess bone structure. An MRI may follow if a soft tissue injury is suspected and further detail is needed.
Step-by-step explanation:
An X-ray should be initially ordered for a 13-year-old who has shoulder pain after taking part in overhead throws. Depending on those results, an MRI may be considered if further detail is needed.
Shoulder injuries in young athletes who participate in activities like overhead throws are common. An X-ray is typically the first imaging modality used to assess bone structure and alignment and to rule out fractures. If the X-ray is inconclusive or if a soft tissue injury, such as a rotator cuff tear or a labrum tear, is suspected, then an MRI (Magnetic Resonance Imaging) may be ordered. This imaging is more detailed for soft tissues, which include muscles, tendons, and ligaments.
Ultrasound imaging is another non-invasive technique that can visualize soft tissue structures. It is often used for dynamic assessments, meaning it can show structures while they are in motion. CT scans, while excellent for bone injuries, are not typically the first choice for soft tissue shoulder injuries in adolescents due to higher radiation exposure compared to an X-ray.
Physicians often use the patient's history, clinical exam, and basic imaging like X-rays as the first step. Additional imaging like MRI or Ultrasound would be at the discretion of the orthopedist based on the initial findings and the patient's response to initial treatments like physical therapy.