I started a weight-lifting program at home two weeks ago. When I increased to 20 pounds for shoulder movements, I felt a pop in my left shoulder. There was a twinge of pain at the time, and the next day I had extreme shoulder pain. I went to see the doctor, and she said I tore the supraspinatus tendon. There were no X-rays or other tests done. Shouldn’t I have X-rays or MRI?

X-rays have limited value in a case like this. Your doctor might have ordered an X-ray if she thought you could have fractured a bone.

MRI (magnetic resonance imaging) is a useful test to identify damaged shoulder tendons. However, it is not always necessary to perform these studies. MRIs are very expensive, and most tendon tears can be accurately identified with a careful physical examination and history.

An MRI is probably not necessary unless the doctor is considering surgery. If you do not get better after a program of physical therapy, the doctor may reconsider ordering an MRI. Getting a second opinion from another doctor may confirm the diagnosis at a lesser cost.