2016Journal of OrthopaedicsOpen access

MR arthrography evaluation in patients with traumatic anterior shoulder instability

Luca Saba, Massimo De Filippo

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Abstract

INTRODUCTION: To evaluate retrospectively the diagnostic accuracy of MR arthrography, compared with arthroscopy, in research of the glenoid labrum tear in patients with a first episode of traumatic anterior shoulder instability (TUBS). MATERIAL AND METHODS: We retrospectively reviewed the MR arthrography shoulder images of 118 patients with a first episode of TUBS, between June 2014 and May 2016. RESULTS: The overall accuracy of MR arthrography compared with arthroscopy of the glenoid labrum lesions was 94%, sensitivity 93%, and specificity 96%. The sensitivity of MR arthrography for Perthes lesion was 71.4%, and for ALPSA lesion, it was 91%. Slap lesion occurred in 11 out of 77 cases (9.3% of 118 cases). The Hill-Sachs lesion occurred in 48 out of 118 cases (40.7%), while the Hill-Sachs reverse lesion in 4 cases (3.4%). CONCLUSIONS: The MR arthrography is accurate in detecting labral injuries. However, other studies are needed to assess the less frequent tear, as Perthes lesion. The presence of the Hill-Sachs lesion could provide useful information about the level of the shoulder instability.

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INTRODUCTION: To evaluate retrospectively the diagnostic accuracy of MR arthrography, compared with arthroscopy, in research of the glenoid labrum tear in patients with a first episode of traumatic anterior shoulder instability (TUBS). MATERIAL AND METHODS: We retrospectively reviewed the MR arthrography shoulder images of 118 patients with a first episode of TUBS, between June 2014 and May 2016. RESULTS: The overall accuracy of MR arthrography compared with arthroscopy of the glenoid labrum lesions was 94%, sensitivity 93%, and specificity 96%. The sensitivity of MR arthrography for Perthes lesion was 71.4%, and for ALPSA lesion, it was 91%. Slap lesion occurred in 11 out of 77 cases (9.3% of 118 cases). The Hill-Sachs lesion occurred in 48 out of 118 cases (40.7%), while the Hill-Sachs reverse lesion in 4 cases (3.4%). CONCLUSIONS: The MR arthrography is accurate in detecting labral injuries. However, other studies are needed to assess the less frequent tear, as Perthes lesion. The presence of the Hill-Sachs lesion could provide useful information about the level of the shoulder instability.

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Available abstract

INTRODUCTION: To evaluate retrospectively the diagnostic accuracy of MR arthrography, compared with arthroscopy, in research of the glenoid labrum tear in patients with a first episode of traumatic anterior shoulder instability (TUBS). MATERIAL AND METHODS: We retrospectively reviewed the MR arthrography shoulder images of 118 patients with a first episode of TUBS, between June 2014 and May 2016. RESULTS: The overall accuracy of MR arthrography compared with arthroscopy of the glenoid labrum lesions was 94%, sensitivity 93%, and specificity 96%. The sensitivity of MR arthrography for Perthes lesion was 71.4%, and for ALPSA lesion, it was 91%. Slap lesion occurred in 11 out of 77 cases (9.3% of 118 cases). The Hill-Sachs lesion occurred in 48 out of 118 cases (40.7%), while the Hill-Sachs reverse lesion in 4 cases (3.4%). CONCLUSIONS: The MR arthrography is accurate in detecting labral injuries. However, other studies are needed to assess the less frequent tear, as Perthes lesion. The presence of the Hill-Sachs lesion could provide useful information about the level of the shoulder instability.

Key concepts: Medicine, Lesion, Bankart lesion, Labrum, Arthroscopy, Radiology, Anterior shoulder, Shoulder joint

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