MR Imaging of the Shoulder: First Dislocation versus Chronic Instability

Gyftopoulos, Soterios; Bencardino, Jenny T.; Palmer, William E.

doi:10.1055/s-0032-1327003

Cited by 15 publications

(6 citation statements)

References 91 publications

(133 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1,2] Various studies have found that patient's age, gender and athletic involvement were reliable predictors for recurrence with age during initial dislocation appearing to be the most common predisposing factor. [3] Rowe et al showed that the rate of recurrence of shoulder dislocation got decreased as patients got old with 83% of patients below age 20, 63% between 20 and 40, and 16% of patients older than 40 likely to have recurrent dislocation. [4] Teslaa et al found that there was a 71% recurrence rate in patients less than 18 years of age at 5-year followup period when compared with the overall group of 16-to 39-year-old patients who demonstrated a recurrence rate of about 55%.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Arthrogram Findings in Recurrent Dislocation of Shoulder

Madhu¹,

Raman²,

Karuppal³

et al. 2017

jemds

View full text Add to dashboard Cite

BACKGROUNDShoulder joint is the most commonly dislocated joint and it is most commonly dislocated anteriorly. Based on aetiology and age, there are associated injuries like injury to anterior-inferior labroligamentous restraints (in young people with traumatic aetiology) and to bony restraints (in elderly people). Injury to labroligamentous structures are best visualised using MRI and MR arthrography. Instability can be anterior, posterior and inferior or multidirectional. Anterior instability are associated with Bankart's lesion and variants of it and injuries to anterior part of Inferior Glenohumeral Ligament (IGHL). With posterior instability lesions expected are reverse Bankart's and reverse Hill-Sachs lesions.

show abstract

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Arthrogram Findings in Recurrent Dislocation of Shoulder

Madhu¹,

Raman²,

Karuppal³

et al. 2017

jemds

View full text Add to dashboard Cite

show abstract

“…While CT scans are the gold standard for assessing bone loss, MRI has been shown to be accurate and reliable for the measurement of GBL. 14,29 In addition, MRI studies have been used recently to define posterior critical bone loss. 1 Given that the present study relied on proportions of bone loss, rather than absolute bone loss, the use of both imaging modalities is not likely to influence the results of the study.…”

Section: Limitationsmentioning

confidence: 99%

Glenoid Bone Loss Pattern in Patients With Posterior Instability Versus Anterior Instability: A Matched Cohort Study

Livesey

Bedrin

Kolevar

et al. 2023

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: The pattern of glenoid bone loss (GBL) in anterior glenohumeral instability is well described. It was recognized recently that posterior GBL after instability has a posteroinferior pattern. Purpose/Hypothesis: The purpose of this study was to compare GBL patterns in a matched cohort of patients with anterior versus posterior glenohumeral instability. The hypothesis was that the GBL pattern in posterior instability would be more inferior than the GBL pattern in anterior instability. Study Design: Cohort study; Level of evidence, 3. Methods: In this multicenter retrospective study, 28 patients with posterior instability were matched with 28 patients with anterior instability by age, sex and number of instability events. GBL location was defined using a clockface model. Obliquity was defined as the angle between the long axis of the glenoid and a line tangent to the GBL. Superior and inferior GBL were measured as areas and defined relative to the equator. The primary outcome was the 2-dimensional characterization of posterior versus anterior GBL. The secondary outcome was a comparison of the posterior GBL patterns in traumatic and atraumatic instability mechanisms in an expanded cohort of 42 patients. Results: The mean age of the matched cohorts (n = 56) was 25.2 ± 9.87 years. The median obliquity of GBL was 27.53° (interquartile range [IQR], 18.83°-47.38°) in the posterior cohort and 9.28° (IQR, 6.68°-15.75°) in the anterior cohort ( P < .001). The mean superior-to-inferior bone loss ratio was 0.48 ± 0.51 in the posterior cohort and 0.80 ± 0.55 ( P = .032) in the anterior cohort. In the expanded posterior instability cohort (n = 42), patients with traumatic injury mechanism (n = 22), had a similar GBL obliquity compared to patients with an atraumatic injury mechanism (n = 20) (mean, 27.73° [95% CI, 20.26°-35.20°] vs 32.20° [95% CI, 21.27°-43.14°], respectively) ( P = .49). Conclusion: Posterior GBL occurred more inferiorly and at an increased obliquity compared with anterior GBL. This pattern is consistent for traumatic and atraumatic posterior GBL. Bone loss along the equator may not be the most reliable predictor of posterior instability, and critical bone loss may be reached more rapidly than a model of loss along the equator may predict.

show abstract

“…The Hill-Sachs lesion should not be confused posterosuperiorly with the bare area at the junction between the footprint of the infraspinatus and the articular cartilage nor posteroinferiorly with the flattened area of the normal humeral neck. On axial images, the Hill-Sachs lesion is typically found at the level of the coracoid process, whereas the neck is far below this level [ 1 35 68 72 77 80 84 85 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 ].…”

Section: What Shouldn’t We Miss In Patients With Recurrent Anterior Dmentioning

confidence: 99%

“…These reversed lesions have the same imaging characteristics as their anterior homonyms. Anteriorly, a reversed Hill-Sachs lesion can be found medial to the lesser tuberosity [ 9 30 46 67 72 74 95 108 109 110 111 112 113 114 115 116 ].…”

Section: What Shouldn’t We Miss In Patients With Recurrent Anterior Dmentioning

confidence: 99%

See 1 more Smart Citation

What can the Radiologist do to Help the Surgeon Manage Shoulder Instability?

Pouliart

Doering

Shahabpour

2016

Journal of the Belgian Society of Radiology

View full text Add to dashboard Cite

Imaging of the shoulder forms an important adjunct in clinical decision making in patients with shoulder instability. The typical lesions related with classic anterior and anteroinferior shoulder dislocation are an anteroinferior labral avulsion with or without bony fragment of bone loss – a (bony) Bankart lesion – and a posterolateral humeral head impaction fracture – the Hill-Sachs lesions. These are relatively straightforward to identify on imaging, although normal variants of the inferior labrum and variants of labral damage may cause confusion. Other capsuloligamentous lesions, often associated with less typical types of instability, are much more difficult to identify correctly on imaging, as they occur in the anterosuperior part of the glenohumeral joint with its many normal variants or because they result in more subtle, and therefore easily overlooked, changes in morphology or signal intensity. This paper aims at describing the appearance of the normal and pathologic glenohumeral joint related to shoulder instability. Ample reference will be given as to why identification of abnormalities, whether normal or pathologic, is important to the surgeon facing a treatment decision.

show abstract

MR Imaging of the Shoulder: First Dislocation versus Chronic Instability

Cited by 15 publications

References 91 publications

Magnetic Resonance Imaging Arthrogram Findings in Recurrent Dislocation of Shoulder

Magnetic Resonance Imaging Arthrogram Findings in Recurrent Dislocation of Shoulder

Glenoid Bone Loss Pattern in Patients With Posterior Instability Versus Anterior Instability: A Matched Cohort Study

What can the Radiologist do to Help the Surgeon Manage Shoulder Instability?

Contact Info

Product

Resources

About