Assessment of the unstable shoulder by computed arthrography

Kinnard, P; Tricoire, J; Levesque, Rejean-Yves; Bergeron, Dominique

doi:10.1177/036354658301100309

Cited by 24 publications

(3 citation statements)

References 4 publications

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“…14 The CT arthrography reportedly has been successful in about 80% to 100% of the cases, but it is known to be ineffective in detecting small labral tears or detachments. 1,5,6,17,19,23,29,39,41,[43][44][45]53,56 Double-contrast CT arthrography may be more precise in delineating labral injury. 1,5 These are invasive procedures that require the injection of contrast material into the shoulder and the use of ionizing radiation.…”

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confidence: 99%

Magnetic Resonance Imaging of the Glenoid Labrum in Anterior Shoulder Instability

Green

Christensen

1994

Am J Sports Med

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Detachment of the anterior inferior labrum and inferior glenohumeral ligament complex from the glenoid is a common lesion encountered in anterior shoulder instability while other types of labral lesions are associated with symptoms that mimic instability. Accurate delineation of labral lesion is, therefore, key in managing shoulder problems. In a prospective double-blinded fashion, we compared the magnetic resonance imaging findings with those noted at surgery in 33 patients with possible anterior shoulder instability. Of 28 surgically confirmed labral lesions, 21 were detected by imaging. Sensitivity was 75%, specificity 100%, while positive and negative predictive values were 100% and 41%, respectively. Overall accuracy was 79%. Based on a literature review and our clinical experience, we developed a classification of glenoid labra according to the type and severity of the lesions. Method of treatment correlated with clinical outcome, using this system, to a statistically significant level. Unfortunately, this system enabled accurate classification with magnetic resonance imaging in only 7 of 33 (21%) labra, with the precision necessary to affect surgical planning in our series. We conclude that magnetic resonance imaging is not useful in the surgical planning for most patients with obvious anterior shoulder instability.

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confidence: 99%

Magnetic Resonance Imaging of the Glenoid Labrum in Anterior Shoulder Instability

Green

Christensen

1994

Am J Sports Med

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“…2-A and 2-B). This type of study best demonstrates acute or chronic bone loss 48 and shows the orientation of the articular surfaces, as the contrast medium outlines the cartilage of the glenoid and humeral head [49][50][51] . A magnetic resonance imaging-arthrogram is better suited for demonstrating soft tissues, although bone deficiencies can still be detected [50][51][52][53] .…”

Section: Imagingmentioning

confidence: 98%

Open Operative Treatment for Anterior Shoulder Instability

Millett

Clavert

Warner

2005

The Journal of Bone & Joint Surgery

117

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The treatment of anterior glenohumeral instability continues to evolve. Open capsulolabral repairs are time-tested and reliable. In an era in which arthroscopic techniques continue to improve, open surgery remains an acceptable option, and there are still certain injury patterns that cannot be adequately addressed arthroscopically. Decision-making regarding surgery for instability is influenced by the surgeon's experience and the relevant pathological findings. Open operative treatment is the preferred approach in many instances of recurrent anterior instability, particularly when there is bone and soft-tissue loss and in revision settings.

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“…Standard arthrography, tomographic arthrography, double contrast CT arthrography, and arthroscopy have all been suggested as diagnostic methods to evaluate the integrity of the glenoid labrum, both in cases of instability and for isolated lesions. 7,9,14,15 The use of magnetic resonance imaging (MRI) as an adjunct for diagnosis of knee injuries has been well-documented in the literature.4, 8,11 MRI offers several advantages over other imaging techniques. It is noninvasive, uses no ionizing radiation, is painless, produces high resolution images of soft tissue, and possesses multiplanar imaging capability.…”

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confidence: 99%

Magnetic resonance imaging of the glenoid labrum

Gross¹,

Seeger

Smith³

et al. 1990

Am J Sports Med

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Shoulder complaints are common in the athletic population. Successful treatment is dependent upon the ability to correctly identify the pathologic changes associated with a specific disorder and arrive at an accurate diagnosis. Labral abnormalities are traditionally associated with glenohumeral instability. Isolated labral tears or degenerative changes may also cause shoulder dysfunction. A reliable clinical tool to assess the status of the labrum would be useful for diagnosis and management of shoulder disorders. The magnetic resonance images of 48 shoulders that had subsequent surgical examination of their labra were reviewed with respect to labral appearance. Labra appearing as abnormal were further classified as torn, degenerative, or eroded. Surgical examination was used as the reference standard. Magnetic resonance imaging demonstrated high levels of sensitivity, specificity, positive and negative predictive values, and accuracy for evaluation of the glenoid labrum. Magnetic resonance imaging is a reliable and accurate method for depicting the status of the glenoid labrum. Magnetic resonance imaging appearance of the labrum may assist the clinician in distinguishing the varying forms of shoulder dysfunction and facilitate diagnosis and effective treatment.

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Assessment of the unstable shoulder by computed arthrography

Cited by 24 publications

References 4 publications

Magnetic Resonance Imaging of the Glenoid Labrum in Anterior Shoulder Instability

Magnetic Resonance Imaging of the Glenoid Labrum in Anterior Shoulder Instability

Open Operative Treatment for Anterior Shoulder Instability

Magnetic resonance imaging of the glenoid labrum

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