Assessment of Acute Lesions of the Biceps Pulley in Patients with Traumatic Shoulder Dislocation Using MR Imaging

Abstract

Background: Shoulder dislocations represent common injuries and are often combined with rotator cuff tears and potentially damage to the biceps pulley. Purpose: To assess the occurrence and type of biceps pulley lesions in patients after traumatic anterior shoulder dislocation using 3T MRI. Methods: Thirty-three consecutive patients were enrolled between June 2021 and March 2022 (14 women, mean age 48.0 ± 19 years). All patients underwent MR imaging at 3 T within one week. Images were analyzed for the presence and type of pulley tears, subluxation/dislocation of the LHBT, rotator cuff lesions, joint effusion, labral lesions, and osseous defects. Results: Seventeen patients (52%) with traumatic anterior shoulder dislocation demonstrated biceps pulley lesions. Of those, eleven patients (33%) showed a combined tear of the sGHL and CHL. All seventeen patients with lesions of the biceps pulley showed associated partial tearing of the rotator cuff, whereas three patients showed an additional subluxation of the LHBT. Patients with pulley lesions after dislocations were significantly older than those without (mean age 52 ± 12 years vs. 44 ± 14 years, p = 0.023). Conclusion: Our results suggest an increased awareness for lesions of the biceps pulley in acute traumatic shoulder dislocation, particularly in patients over 45 years.

Biceps Pulley Lesions: Diagnostic Accuracy of Nonarthrographic Shoulder MRI and the Value of Various Diagnostic Signs

“…The resolution of standard 1.5T MRI is inadequate for distinguishing between these different components. 15 According to our arthroscopic reports, there was concordance with previous studies regarding SGHL lesions in various patient groups. 7,16 Martetschläger et al 2 found that 36% of their patients with BP lesions had intact medial CHL/SGHL complexes with lateral CHL lesions, making them unclassifiable by Habermeyer's classification.…”

“…Martetschläger et al classification 2 relied on arthroscopic findings and classified BP lesions into medial sling (medial CHL/SGHL), lateral sling (lateral CHL) injuries or combined. The resolution of standard 1.5T MRI is inadequate for distinguishing between these different components 15 …”

“…Nonarthrographic shoulder MRI is routinely performed for the assessment of different shoulder pathologies. Despite the advantages of MRI, such as high soft‐tissue resolution and noninvasiveness, few studies have investigated the diagnostic accuracy of nonarthrographic MRI in detecting BP lesions and LHB instability 11–13 . Therefore, we aimed to assess the diagnostic accuracy of nonarthrographic shoulder MRI for detecting BP lesions, using arthroscopy results as the reference standard.…”

“…Despite the advantages of MRI, such as high soft-tissue resolution and noninvasiveness, few studies have investigated the diagnostic accuracy of nonarthrographic MRI in detecting BP lesions and LHB instability. [11][12][13] Therefore, we aimed to assess the diagnostic accuracy of nonarthrographic shoulder MRI for detecting BP lesions, using arthroscopy results as the reference standard. We also aimed to assess the diagnostic value of MRI signs for BP lesions to avoid missing hidden lesions and enable early and suitable management.…”

Correlation between the morphological features of the biceps groove and injuries to the biceps pulley and the long head tendon of the biceps

“…In this study, we found a positive correlation between pulley structure injury and Lesions of LHBT.The pulley structure of LHBT comprises the superior glenohumeral ligament (SGHL), the coracohumeral ligament (CHL), the supraspinatus muscle, and the subscapularis tendon, which is a soft tissue stabilizing device before the biceps long head tendon enters the bone pulley groove. Pulley structure injury is an important reason for the anterior pain of the shoulder joint [16][17][18]. Recently, more attention has been paid to pulley injury.…”