Do I Need a CT Scan Before Shoulder Replacement?

A CT scan is often one of the most important planning tools before shoulder replacement surgery. It allows the surgeon to understand the exact shape, version, wear pattern, and bone quality of the shoulder socket before surgery.

Dr. Streit uses advanced imaging selectively to plan total shoulder replacement, reverse shoulder replacement, and complex revision shoulder reconstruction.

Why X-rays are not always enough

X-rays are usually the starting point for diagnosing shoulder arthritis. They show joint space narrowing, bone spurs, deformity, and whether the ball and socket are aligned.

However, X-rays are two-dimensional. They may not fully show how much the socket has worn down, whether the socket is tilted backward, whether bone loss is present, or whether an augmented implant may be needed.

A CT scan provides a three-dimensional understanding of the shoulder, which can be especially valuable when planning shoulder replacement.

What the CT scan helps evaluate

• Glenoid version, meaning whether the socket is tilted forward or backward
• Glenoid inclination, meaning whether the socket is tilted up or down
• Posterior bone loss and asymmetric socket wear
• Bone quality and remaining bone stock
• Whether an anatomic or reverse shoulder replacement is more appropriate
• Whether augmented implants or bone grafting may be needed
• Implant size, position, and fixation strategy

This is particularly important in patients with severe arthritis, prior surgery, deformity, bone loss, fracture history, or revision shoulder replacement.

Does every patient need a CT scan?

Not necessarily. Some straightforward cases can be planned with high-quality X-rays and clinical evaluation.

However, in modern shoulder replacement surgery, CT-based planning has become increasingly common because the socket side of the shoulder is often the most important factor in long-term implant performance.

For complex arthritis, reverse shoulder replacement, glenoid bone loss, or revision cases, a CT scan is often extremely helpful.

What this means for patients

A CT scan is not ordered simply to obtain more imaging. It is ordered when it improves surgical planning, implant selection, accuracy, and decision-making.

The goal is to enter surgery with the most precise plan possible—so that the implant matches the patient’s anatomy and has the best chance of long-term success.