Anatomy, Variants, and Pathologies of the Superior Glenohumeral Ligament: Magnetic Resonance Imaging with Three-Dimensional Volumetric Interpolated Breath-Hold Examination Sequence and Conventional Magnetic Resonance Arthrography

Abstract

The purpose of this review was to demonstrate magnetic resonance (MR) arthrography findings of anatomy, variants, and pathologic conditions of the superior glenohumeral ligament (SGHL). This review also demonstrates the applicability of a new MR arthrography sequence in the anterosuperior portion of the glenohumeral joint. The SGHL is a very important anatomical structure in the rotator interval that is responsible for stabilizing the long head of the biceps tendon. Therefore, a torn SGHL can result in pain and instability. Observation of the SGHL is difficult when using conventional MR imaging, because the ligament may be poorly visualized. Shoulder MR arthrography is the most accurately established imaging technique for identifying pathologies of the SGHL and associated structures. The use of three dimensional (3D) volumetric interpolated breath-hold examination (VIBE) sequences produces thinner image slices and enables a higher in-plane resolution than conventional MR arthrography sequences. Therefore, shoulder MR arthrography using 3D VIBE sequences may contribute to evaluating of the smaller intraarticular structures such as the SGHL.

Klinische oder radiologische Diagnose des Impingements

“…Abb. 1, 2; [3,4,5]). Neuere Untersuchungen zeigen, dass ein höherer "scapular angle" häufiger mit einem Impingementsyndrom vergesellschaftet ist (.…”

How Can New Imaging Modalities Help in the Practice of Radiology?

“…These particles are usually not visualized by routine sequences. Concordantly, the VIBE sequence is sensitive and will reveal hemosiderin particles in the synovium and joint space as well as intra-articular air bubbles [70][71][72]. …”

The Ramp Test: An Arthroscopic Technique for Confirming Intra-articular Subluxation and Instability of the Long Head of the Biceps Tendon Within the Shoulder

“…Biceps intra-articular instability can cause anterior shoulder pain as the superior glenohumeral ligament (SGHL) begins to fail or completely fails. 1 The coracoid itself can impinge within this area, creating injury, referred to as “coracoid impingement.” 2 …”

“…The SGHL functions to maintain the biceps tendon in an exact position on the anterior-superior humeral head articular cartilage through full range of motion and to allow the tendon to move freely in and out of the joint during motion. 1 The breakdown of the SGHL—laxity, partial tearing, or full tearing—will determine whether the hidden lesion is present. 5 Finding this lesion during shoulder arthroscopy is determined by the ramp test.…”

“…Magnetic resonance imaging has some specific findings for biceps instability, but these require complete rupture or laxity in the SGHL to show the tendon subluxating out of the bicipital bone tunnel. 1 After many cadaveric dissections and extensive intraoperative use in a teaching institution, the ramp test is now a conformational simple test that can be used intraoperatively to help shoulder surgeons and developing resident surgeons to look at the anatomic structures and determine whether the SGHL is normal, lax, or torn. 4 The test is very simple and can be completed within 15 seconds during the arthroscopic evaluation of the shoulder joint to determine SGHL integrity.…”