Thirty-eight cases of histologically confirmed chondromyxoid fibroma were reviewed and their radiographic features recorded. These findings, coupled with a review of the English-language medical literature, suggest that this rare, benign bone tumor has a characteristic but not specific radiographic appearance and may often mimic more common tumors. Chondromyxoid fibroma may occur anywhere in the skeleton, but almost half of the cases occur around the knee. The possibility of chondromyxoid fibroma should always be considered when a focal bone lesion is evaluated that has geographic bone destruction, a sclerotic rim, lobulated margins, and septation. The diagnosis of chondromyxoid fibroma is most likely when the patient is in the 2nd decade of life.

The appearance of the supraspinatus tendon and anterior capsular mechanism was analyzed in 60 asymptomatic shoulders with magnetic resonance (MR) imaging. The images were reviewed with special attention to findings that simulate pathologic conditions, as defined by means of currently accepted criteria. On T1-weighted and proton-density (PD) spin-echo (SE) images, intermediate signal intensity was present within the supraspinatus tendon in most shoulders. Focal signal intensity within the distal tendon was particularly common finding, being present in 95% (57 of 60) of shoulders on PD images. Focal obliteration of the subacromial-subdeltoid fat stripe and acromioclavicular joint arthrosis were seen in 95% (57 of 60) and 48% (29 of 60) of the subjects, respectively. There was considerable variation in the shape of the anterior glenoid labrum-glenohumeral ligament (GHL) complex. The labrum may appear triangular, round, crescentic, or absent. The middle and inferior GHLs lie in proximity to the upper half of the anterior labrum; the cleavage plane between the ligaments and the labrum can mimic a tear at MR imaging.

Background: Symptomatic total acromio-clavicular joint dislocation (Rockwood et al. types III-VI) may be treated by surgical reconstruction. Aim: To describe an arthroscopically assisted technique to reconstruct anatomically the coracoclavicular ligaments in acute or chronic (> 6 weeks) acromio-clavicular joint dislocation. Methods: This new technique involves arthroscopic exposure of the coracoid process. Prior to introducing this technique, cadaveric studies were undertaken.Results: Five patients underwent this procedure. All engaged in regular sports or manual-type work. All patients were discharged the same day with the shoulder immobilised for 4 weeks, with no heavy lifting for 3 months. All patients were pain-free at 6 weeks with full function and maximum Constant scores at 3 months. There have been no complications. Conclusions: A new, safe technique is described which provides a cosmetically acceptable, anatomically solid reconstruction of the coraco-clavicular ligaments.

One hundred two computed tomographic (CT) arthrograms of the shoulder were retrospectively reviewed and compared with conventional double-contrast arthrograms from 101 patients (24 females and 77 males aged 9-70 years). One- to 4-year follow-up was obtained in 84 patients, 40 of whom underwent open-shoulder surgery or arthroscopy. Morphology of the normal portions of each labrum was categorized according to length, width, and tip shape. Correlation between morphology and age was weak, but abnormal labra were more common in younger patients. Conventional radiography was more accurate for detecting bony glenoid margin fractures, but CT was more accurate for detecting Hill-Sach fractures. CT was also more reliable than conventional arthrography in the detection of rotator cuff tears. Hence, few if any conventional radiographs are necessary between contrast material injection and CT imaging. A reduction in the number of images obtained will result in decreased radiation dose, less cost, and shorter examination time without loss of diagnostic accuracy.

Background Fatty infiltration and muscle atrophy of supraspinatus are used as markers of chronicity in rotator cuff tears and are known to both be independently related to poorer outcomes following surgical repair.1 We hypothesized that supraspinatus muscle atrophy and fatty infiltration increases with age irrespective of whether the rotator cuff is intact and therefore cannot be used as accurate markers for chronicity. Method Retrospective review of 280 patients who underwent 3.0 T shoulder MRI’s with either a normal scan or rotator cuff tear. Two independent observers reviewed the images. Data collected included intact rotator cuff tendons looking specifically at supraspinatus muscle height/length: suprascapular fossa ratio, tangent sign and Goutallier grade for fatty infiltration. Results There were 90 scans with intact rotator cuff tendons. Mean age was 51 years (range 17–86); 52 males, 38 females. On multiple regression analysis, there was a positive correlation of age with fatty infiltration and muscle atrophy on all parameters in the normal intact cuff. Females were significantly more likely than males to have a higher grade of fatty infiltration. Conclusion Age and female gender are risk factors for rotator cuff atrophy and fatty infiltration in patients with normal rotator cuffs. Therefore, these parameters should be used with caution by surgeons when deciding on tear chronicity and the potential to repair the torn rotator cuff.