MRI is the gold standard but ultrasound is also an option. Be guided by what the treating doctor recommends, after he has made a thorough physical examination which in itself can tell quite a bit. No doctors of quite the same caliber as Prof. Mason in Pattaya (or anywhere else in Thailand). Best shoulder specialist in Patts is https://www.bangkokhospital.com/en/pattaya/doctor/pratya-jaratjitwilai-m-d Will probably cost more there than going to Bangkok even including travel costs.. But of course save you the hassle of a trip at a time when your arm mobility is limited. If finances are very limited then I would recommend going to Queen Sirikit (Naval Hospital). The process will be longer there/more red tape and waits. But less expensive. Before considering any surgical intervention (if it is recommended) definitely go up to Bangkok and consult Prof. Mason for a second opinion bringing all records with you. The main issues for you are to determine (1) if there is a rotator cuff injury (2) if so the extent of it and (3) whether any other injuries are present. Note that hairline fractures do not always show on Xray right away. Once there is a clear diagnosis that includes the extent and thickness of any tear, next issue becomes treatment. If it is a partial tear, conservative management would usually be recommended at least initially - arm sling, rest, PT, anti-inflammatories. The decision tree is more complicated if it is a complete tear, especially from traumatic cause rather than degenerative ones. Patient specific factors like age, activity level, risk factors for surgery would need to be considered. The experience of the doctor is quite important at that juncture in determining best course of action for specific patient.
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