Synovial fold of the posterior shoulder joint capsule

Novak, Leon; Lee, Joong K.; Saleem, Asgar M.

doi:10.1007/s00256-008-0635-0

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…For the posterior synovial fold of the shoulder joint, capsular morphologic changes on MRI or MR arthrography have been described in only one study. 4 Unlike our study, this study had a small patient population. Moreover, the study did not provide detailed comments about the location, size and morphologic types of posterior capsular fold, and accompanying capsulolabral-ligamentous abnormalities.…”

Section: Discussionmentioning

confidence: 83%

“…Although they retrospectively investigated a limited number of MR arthrography patients, fewer posterior synovial folds were observed on shoulder MR images than on shoulder MR arthrography. We studied a larger MR arthrographic patient population, and our results had a few differences than those of Novak et al 4 We performed MRI at the same period for each patient who underwent MR arthrography; 17% of our patients with posterior synovial folds who were diagnosed with MR arthrography had normal MRI features. Interestingly, 48.6% of these patients had doubled and tripled posterior labrocapsular morphology in MR images.…”

Section: Discussionmentioning

confidence: 88%

“…The actual prevalence of the posterior synovial fold in the shoulder is unknown. However, an MRI and MR arthrography study performed by Novak et al 4 showed that that frequency of anomalies in shoulder MR arthrography and MRI was 2.7 and 1.5%, respectively. Although they retrospectively investigated a limited number of MR arthrography patients, fewer posterior synovial folds were observed on shoulder MR images than on shoulder MR arthrography.…”

Section: Discussionmentioning

confidence: 98%

“…8 Histopathological studies of the posterior joint capsule could elucidate the true nature of the posterior synovial fold. 4 However, we believe that the visualization of what we are calling the posterior synovial fold is either a normal structure like the anterior glenohumeral ligaments or a normal variant like the synovial plica in the knee which can sometimes be inflamed and symptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…The depth of the posterior synovial fold was measured on axial MR arthrography images at the widest portion along a perpendicular line to the imaginary capsular curve (Figure 1a-b). The MR arthrographic diagnosis criteria of posterior synovial fold included: (1) a focal thickness at least 2 mm (the depth and width of the focal capsular thickness ≥2 mm) of the posterior shoulder joint capsule on axial T 1 weighted fat-suppressed MR arthrograms, 4 (2) extension in a craniocaudal oblique direction of the focal thickness of the posterior joint capsule on axial and sagittal oblique T 1 weighted fat-suppressed MR arthrograms.…”

Section: Mr Arthrographic Measurement Criteria For Posterior Synovialmentioning

confidence: 99%

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MR arthrographic characterization of posterior capsular folds in shoulder joints

Oğul

Tuncer

Köse

et al. 2019

BJR

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Direct MR arthrography of the glenohumeral joint with intra-articular injection of diluted gadolinium chelates has described for shoulder disorders including capsulolabral pathologies, glenohumeral ligament damages, and rotator cuff ruptures. 1,2 It is also a primary imaging modality for evaluation of labroligamentous complex anatomy and variations. 3 Although synovial folds in the posterior shoulder joint capsule are rare, they can mimic a posterior labral defect on conventional MR images. 4 Thus, correct identification of labrocapsular anatomic variants such as posterior synovial fold and atypical labral morphology is very important to avoid unnecessary arthroscopic surgery. Because direct MR arthrography of the shoulder joint causes separation of intra-articular structures with capsular distention, 5 differential diagnosis of labral detachment and the posterior synovial fold can be performed more easily with MR arthrography. In our daily practice, we relatively often encounter suspicious posterior labral detachment on conventional MR images of some patients without clinical evidence for

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Mr Arthrographic Measurement Criteria For Posterior Synovialmentioning

confidence: 99%

See 3 more Smart Citations

MR arthrographic characterization of posterior capsular folds in shoulder joints

Oğul

Tuncer

Köse

et al. 2019

BJR

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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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Incidence, location and classification of glenoid labrum meniscoid folds

Natsis

Konstantinidis

Moebius

et al. 2016

Arch Orthop Trauma Surg

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Synovial fold of the posterior shoulder joint capsule

Abstract: Although rare, the posterior synovial fold can be recognized and should not be confused with a posterior labral tear. Further investigation is needed to assess its histologic properties and its clinical significance.

Cited by 10 publications

References 17 publications

MR arthrographic characterization of posterior capsular folds in shoulder joints

MR arthrographic characterization of posterior capsular folds in shoulder joints

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

Incidence, location and classification of glenoid labrum meniscoid folds

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