MR arthrographic characterization of posterior capsular folds in shoulder joints

Oğul, Hayri; Tuncer, Kutsi; Köse, Mehmet; Pirimoğlu, Berhan; Kantarcı, Mecit

doi:10.1259/bjr.20180527

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…The prevalence of posterior capsular folds detected on MR arthrography has been reported as 5.8%. 5 The posterior capsular folds of the shoulder joint have been described in detail in several studies. However, to our knowledge, the sonographic or sonoarthrographic features of the posterior capsular folds have not been reported in the Englishlanguage literature.…”

Section: Discussionmentioning

confidence: 99%

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Pathologies and anatomical abnormalities of posterior labrocapsular structures of the glenohumeral joint are relatively uncommon. [1][2][3][4][5] Reverse Bankart lesion, which is a separation of the posteroinferior labrum from the glenoid caused by posterior shoulder instability, is the most common among these pathologies. Posterior instability represents only 2-4% of all shoulder instabilities.

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Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint

Oğul

Taş

et al. 2020

The British Journal of Radiology

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Objective: To describe the posterior labral lesions and labrocapsular abnormalities of the shoulder on sonoarthrography and to compare these findings with MR arthrography results. Methods: 82 shoulders were initially evaluated with ultrasonography and MRI and then were examined with sonoarthrography and MR arthrography following intraarticular injection of diluted gadolinium solution. The ultrasonography images were prospectively evaluated for the presence of posterior labral tear, sublabral cleft, and posterior capsular abnormalities by two radiologists. The diagnostic accuracy of sonoarthrography in the detection of posterior labral tears and posterior labrocapsular variants was compared with that of MR arthrography. Results: In sonoarthrographic examinations of 82 shoulders, 5 and 6 posterior labral tears were identified by Observer 1 and 2, respectively. Moreover, 6 and 7 posterior sublabral clefts, and 2 and 3 posterior synovial folds were identified by Observer 1 and 2, respectively. All the 82 patients were examined with MR arthrography; however, only 14 patients underwent arthroscopic examination. No significant difference was found among the 82 patients with regard to age, gender, and the prevalence of posterior labral tear, posterior labral cleft, and posterior synovial fold (p > 0.05). Interobserver variability showed substantial agreement between the sonoarthrographic and MR arthrographic results of the posterior labrocapsular structures (κ = 0.71, p < 0.05). Conclusion: Posterior labral tears and posterior synovial folds of the shoulder joint can be evaluated non-invasively by sonoarthrography. Advances in knowledge: Variations and pathologies of posterior labrocapsular structures of the glenohumeral joint are relatively uncommon. Direct (MR) arthrography is the gold-standard imaging modality to evaluate of posterior labrocapsular abnormalities of the glenohumeral joint. Sonoarthrography of the glenohumeral joint may be utilized in clinical practice in patients with contraindications to (MRI).

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confidence: 99%

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Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint

Oğul

Taş

et al. 2020

The British Journal of Radiology

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Magnetic resonance arthrography with positional manoeuvre for the diagnosis of synovial fold of posterior shoulder joint capsule

Keles,

Ogul,

Tuncer

et al. 2024

Eur Radiol

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Objectives The objective of this study is to prospectively assess the effectiveness of shoulder magnetic resonance (MR) arthrograms with positional manoeuvres in detecting posterior synovial folds. Methods Two radiologists independently assessed all axial MR arthrograms in internal rotation, neutral position, and external rotation for the presence of a posterior synovial fold. The diagnostic performances of the MR arthrograms were then compared, with results validated through arthroscopy. Results Arthroscopy was performed on 81 of the 150 patients included in the study. A posterior synovial fold was identified arthroscopically in eleven of these patients. Measurements of the posterior synovial fold obtained in external rotation and the neutral position of the arm showed a significant correlation with arthroscopic results (p < 0.05). For detecting the posterior synovial fold with arthroscopic correlation, the sensitivity and specificity values for observer 1 and observer 2 were 100–81.4% and 100–88.6%, respectively, for MR arthrograms in the neutral position; 100–52.9% and 100–62.9% for MR arthrograms in external rotation; and 100–95.7% and 81.8–98.6% for MR arthrograms in internal rotation. There was a fair agreement for MR arthrography in external rotation for detecting posterior synovial folds, while MR arthrograms in internal rotation and neutral position showed near-perfect and significant interobserver agreement. Conclusion The rotational positions of the humeral neck during MR arthrographic examination can influence the diagnostic specificity and sensitivity of axial MR arthrograms in detecting the posterior synovial fold. Clinical relevance statement The posterior synovial fold can mimic a posterior labral detachment. Therefore, its correct identification is crucial in order to avoid unnecessary surgical procedures. Key Points Movement of the shoulder may introduce variability in MR arthrography appearance. Rotation of the humeral neck during MR arthrography can affect diagnoses in posterior synovial fold detection. Given that posterior synovial folds can imitate posterior labral detachment, their correct identification is crucial to avoid unnecessary surgical procedures.

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Posterior shoulder labrocapsular structures in all aspects; 3D volumetric MR arthrography study

Oğul

Taydaş

Sakçı

et al. 2021

The British Journal of Radiology

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Pathologies of the posterior labrocapsular structures of the shoulder joint are far less common than anterior labrocapsuloligamentous lesions. Most of these pathologies have been associated with traumatic posterior dislocation. A smaller portion of the lesions include posterior extension of superior labral anteroposterior lesions, posterior superior internal impingement, and damage to the posterior band of the inferior glenohumeral ligament. Labrocapsular anatomic variations of the posterior shoulder joint can mimic labral pathology on conventional MR and occasionally on MR arthrographic images. Knowledge of this variant anatomy is key to interpreting MR images and studying MR arthrography of the posterior labrocapsular structure to avoid misdiagnosis and unnecessary surgical procedures. In this article, we review normal and variant anatomy of the posterior labrocapsular structure of the shoulder joint based on MR arthrography and discuss how to discriminate normal anatomic variants from labrocapsular damage.

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MR arthrographic characterization of posterior capsular folds in shoulder joints

Cited by 4 publications

References 12 publications

Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint

Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint

Magnetic resonance arthrography with positional manoeuvre for the diagnosis of synovial fold of posterior shoulder joint capsule

Posterior shoulder labrocapsular structures in all aspects; 3D volumetric MR arthrography study

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