A prospective comparison of computerized arthrotomography and magnetic resonance imaging of the glenohumeral joint

Abstract

Twenty-five patients with shoulder instability or shoulder pain of undetermined etiology were prospectively evaluated with magnetic resonance imaging and computerized arthrotomography. Actual lesions were determined by arthroscopy or at the time of open surgical repair. The images obtained were interpreted independently by three radiologists blinded to both surgical results and the results of previous diagnostic tests. Sensitivity, specificity, and accuracy were determined for each imaging technique for a variety of pathologic entities, including anterior and posterior labral abnormalities, capsular redundancy, biceps-labral complex abnormalities, humeral head (Hill-Sachs) impression lesions, and glenohumeral loose bodies. Analysis of imaging techniques also included construction of receiver operator curves for labral abnormalities. Magnetic resonance imaging showed better diagnostic results in the evaluation of glenoid labral and humeral head impression lesions (P < 0.05). Both imaging techniques were equally successful in identifying biceps-labral lesions and intraarticular loose bodies within the glenohumeral joint. Neither imaging technique was consistent in the evaluation of capsular redundancy. Receiver operator curve analysis confirmed that magnetic resonance imaging was the more accurate imaging study in evaluating anterior and posterior glenoid labral abnormalities.

Results and factors affecting outcome of revision surgery for shoulder instability

“…Magnetic resonance imaging was not routinely performed. 15 Particular attention was given to the presence or absence of a Bankart lesion, the status of the capsule, the status of the rotator cuff interval (open or closed), 8 and the quality of the subscapularis tendon. Bankart lesions were described as either soft tissue or bony.…”

A prospective, double-blind comparison of magnetic resonance imaging and arthroscopy in the evaluation of patients presenting with shoulder pain

“…Particularly with repetitive overhead motion, chronic impingement often results in rotator cuff degeneration and, ultimately, a partial-or fullthickness tear. 7,9 Recently, however, the concept of impingement as a primary mechanical entity has been questioned. 5,11,19,23,27 The treatment of patients who present with shoulder pain and impingement varies with the stage of the process.…”

“…3 MRI also provides high soft-tissue contrast, multiplanar capability, and improved resolution over ultrasound. 3,4,9,20 Furthermore, MRI has an excellent ability to identify the various structures in and around the shoulder joint. 10,13,22 There have been numerous reports comparing the diagnostic ability of MRI with that of arthrography, ultrasound, and arthroscopy.…”

Evaluation and Management of Posterior Shoulder Instability

“…35,41 The infraspinatus and teres minor also play a significant role in stabilization at extreme ranges of motion. 31 Lippitt and Matsen 43 described 2 main dynamic stabilizing mechanisms: scapulohumeral balance and concavity compression. A larger glenoid arc provides stability for a larger range of joint force angles.…”