Direct MR arthrography of the shoulder under axial traction: Feasibility study to evaluate the superior labrum‐biceps tendon complex and articular cartilage

Abstract

Purpose: To assess the value of adding axial traction to direct MR arthrography of the shoulder, in terms of subacromial and glenohumeral joint space widths, and coverage of the superior labrum-biceps tendon complex and articular cartilage by contrast material.Materials and Methods: Twenty-one patients investigated by direct MR arthrography of the shoulder were prospectively included. Studies were performed with a 3 Tesla (T) unit and included a three-dimensional isotropic fat-suppressed T1-weighted gradient-recalled echo sequence, without and with axial traction (4 kg). Two radiologists independently measured the width of the subacromial, superior, and inferior glenohumeral joint spaces. They subsequently rated the amount of contrast material around the superior labrum-biceps tendon complex and between glenohumeral cartilage surfaces, using a threepoint scale: 0 ¼ no, 1 ¼ partial, 2 ¼ full.Results: Under traction, the subacromial (D ¼ 2.0 mm, P ¼ 0.0003), superior (D ¼ 0.7 mm, P ¼ 0.0001) and inferior (D ¼ 1.4 mm, P ¼ 0.0006) glenohumeral joint space widths were all significantly increased, and both readers noted significantly more contrast material around the superior labrum-biceps tendon complex (P ¼ 0.014), and between the superior (P ¼ 0.001) and inferior (P ¼ 0.025) glenohumeral cartilage surfaces.Conclusion: Direct MR arthrography of the shoulder under axial traction increases subacromial and glenohumeral joint space widths, and prompts better coverage of the superior labrum-biceps tendon complex and articular cartilage by contrast material.

Diagnostic performance of CT-arthrography and 1.5T MR-arthrography for the assessment of glenohumeral joint cartilage: a comparative study with arthroscopic correlation

“…Despite recent achievements in dose reduction in musculoskeletal CT, CTA exposes patient to ionizing radiation, so efforts should focus on MRA [33][34][35]. 3-T MRA with the use of newly developed gradient echo or spin echo based isotropic 3D sequences could be of interest, as well as more specific imaging techniques such as the balanced steady-state free precession (SSFP) techniques, or the use of traction imaging [6,8,[36][37][38][39].…”

Accuracy of MRI in diagnosing intra-articular pathology of the long head of the biceps tendon: results with a large cohort of patients

“…It can evaluate intraarticular lesions and partial tears more precisely. Therefore, MRI is preferred as a diagnostic tool for various musculoskeletal pathologies including shoulder joint disorders [11, 16–18]. However, only a small number of known studies have examined MRI’s efficacy for diagnosing LHBT pathology.…”

Elbow MR arthrography with traction

“…MRA with axial traction has been evaluated with success in the shoulder, [11][12][13] hip, [14][15][16][17][18][19][20][21] knee, 22 wrist, [23][24][25][26][27][28][29][30] ankle 31,32 and metatarsophalangeal 33 and metacarpophalangeal joints. 34 To the best of our knowledge, there is no study comparing MRA of the elbow with and without traction.…”