A 20-year-old college football offensive lineman undergoes arthroscopic right shoulder surgery for the injury shown in Figure A. Post-operatively he complains of burning pain in the region marked in yellow on Figure B. No Comments The posterior shoulder capsule plays a significant role in preventing posterior shoulder dislocation, particularly at the extremes of internal humeral rotation, the position in which most posterior dislocations occur. Usually it is an incidental finding and regarded as a normal variant. It is better visualized in ABER position.Articular cartilage lesions are best demonstrated with MR arthrography. The biceps looked stable. Occasionally, a SLAP (superior labrum, anterior and posterior) fracture, which represents a superior humeral head compression . In addition to the discrepancy in posterior labral tear evaluations, radiologist 1 documented more pathology throughout the shoulder than radiologist 2. . Oper Tech Sports Med 2016;24(3):181-188. This is not always the case. Harper and colleagues17 similarly developed a classification scheme with normal, mild, moderate, and severe glenoid dysplasia. Shoulder dislocations account for 90% of shoulder instability cases and usually occur after a fall during sport or work activities ().This glenohumeral joint instability has been defined with the acronyms TUBS (traumatic, unidirectional, Bankart, surgery is the main treatment) ().Associated injuries to the labrum, to the glenoid bone, described in up to 40% of the cases (), and . HHS Vulnerability Disclosure, Help -, J Shoulder Elbow Surg. The capsule is a broad ligament that surrounds and stabilizes the joint. found in 3-5% of patients undergoing routine MRI of the shoulder 12, 13 Denervation of muscle is identified on MR images initially by the presence of diffuse, homogeneous muscle . Posterior shoulder instability is a relatively rare phenomenon compared to anterior instability, comprising only 5-10% of all shoulder instability. This is called a posterior labral tear. Evaluate the TCO of your PACS download >, 750 Old Hickory Blvd, Suite 1-260Brentwood, TN 37027, Focus on Musculoskeletal and Neurological MRI, Collateral Ligament Injuries of the Fingers, Tannenbaum E and Sekiya JK. Posterior labral tear; < 15 decrease in affected shoulder internal rotation compared to contralateral shoulder . 15,16). Notice red arrow indicating a small Perthes-lesion, which was not seen on the standard axial views. Uncategorized. If there is a related partial thickness rotator cuff tear, there may also be lateral (on the side) pain. This procedure greatly enhances the diagnostic accuracy by allowing tears . Overall, MRI had an accuracy of 76 %, a PPV of 24 %, and a NPV of 95 %. Study the labrum in the 3-6 o'clock position. Methods: Tearing of the inferior glenohumeral ligament at the humeral attachment (blue arrow) is also evident. The management of these labrum injuries will depend on the classification, severity of the injury and the stability of the shoulder. 2000 Jan;214(1):267-71 Tears of the supraspinatus tendon are best seen on coronal oblique and ABER-series. Weishaupt D, Zanetti M, Nyffeler RW, Gerber C, Hodler J. Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability. Careers. 4B), which is what one would intuitively expect. Posterior Labral Tear. On conventional MR labral tears are best seen on fat-saturated fluid-sensitive sequences. With increased advancements in CT and MRI, more subtle forms of glenoid dysplasia have been recognized. Orthop J Sports Med. MRI is well recognized as an effective means to diagnose internal impingement of the shoulder. (A) Lightbulb sign demonstrating rounded appearance of the humeral head with a posterior glenohumeral dislocation. Apart from that, CT is superior to MR in assessing bony structures, so this modality is helpful in detecting co-existing small glenoid rim fractures. (14a) Normal capsular appearance on an axial fat-suppressed T1-weighted MR arthrographic image. The labrum is the cartilage dish that sits between the ball and the socket configuration of the shoulder joint. In a 34 year-old male following an acute subluxation event, a tear is present along the base of the posterior labrum with edema and irregularity noted at adjacent posterior periosteum (arrow). The blunted configuration of the posterior part means some wear and tear and erosion. of the biceps in the bicipital groove. 2. Insertion of the shoulder capsule onto the labrum or glenoid has been categorized previously according to a system by Mosley et al. J Am Med Assoc 117: 510-514, 1941. Modern imaging techniques, in particular MRI, have greatly increased our ability to accurately diagnose posterior glenohumeral instability, and accurate recognition and characterization of the relevant abnormalities are critical for proper diagnosis and patient management.5, Multiple shoulder structures are important in resisting shoulder instability. Probing of the posterior labrum is needed to rule out a subtle Kim lesion. 4. Study the cartilage. A small chondral defect is present (arrowhead) adjacent to the free edge of the posterior labrum. government site. Radiographic features MRI. Notice the fibers of the inferior GHL. Notice that the supraspinatus tendon is parallel to the axis of the muscle. As joint instability is often present, capsuloplasty may be added to the procedure. 2006; 240(1):152-160. The anterosuperior labrum is absent in the 1-3 o'clock position and the middle glenohumeral ligament is usually thickened. The glenohumeral joint has the following supporting structures: The tendon of the subscapularis muscle attaches both to the lesser tuberosity aswell as to the greater tuberosity giving support to the long head Description. Clipboard, Search History, and several other advanced features are temporarily unavailable. Radiology 2008; 248:185193. Notice superior labrum and attachment of the superior glenohumeral ligament. MRI of the shoulder second edition 5). Unlike the anterior labrum, rarely do we have a posterior dislocation of the shoulder. (14b) In a 39 year-old weightlifter with persistent posterior shoulder pain and instability, the axial image reveals the posterior capsule outlined by arthrographic fluid along both sides of the capsule, strongly suggestive of a capsular tear. . Objective The purpose of this study is to evaluate the accuracy of MR arthrography in detecting isolated posterior glenoid labral injuries using arthroscopy as the reference standard. Posterior labral tears will demonstrate the absence of the labrum or morphologic distortion, contrast, or fluid infiltration [].Four primary diagnostic characteristics can determine pathologic tearing versus an anatomic variant: intrasubstance signal intensity, margins, orientation, and extension. This site needs JavaScript to work properly. Examples include the reverse Bankart lesion, the POLPSA lesion, and the posterior GLAD lesion (sometimes referred to as a PLAD lesion) (Figs. 5,6,7 The classic MRI findings of internal impingement, as seen in this month's case, include partial articular surface tears at the posterior supraspinatus/anterior infraspinatus insertion, greater tuberosity bony changes, and tearing of the . Since that time, other authors have expanded this classification to the current . The anterior labrum is absent in the 1-3 o'clock position and there is a thickened middle GHL. The following algorithm has been previously proposed 25. The labrum has the same effect on the shoulder as the rounded lip of a golf tee has to a golf ball. The concavity at the posterolateral margin of the humeral head should not be mistaken for a Hill Sachs, because this is the normal contour at this level. These terms are interchangeable because there is underdevelopment of the posterior inferior aspect of the glenoid. In cases of severe dysplasia, advanced rounding and posterior sloping of the posterior glenoid is seen, and pronounced thickening of the labrum and other adjacent posterior soft tissues is apparent. An os acromiale must be mentioned in the report, because in patients who are considered for subacromial decompression, sharing sensitive information, make sure youre on a federal A 27-year-old male bodybuilder presents to the office with vague, deep shoulder pain and weakness with his bench press. They developed a classification system in which a pointed glenoid on axial imaging sequences is a normal-appearing glenoid without dysplasia, a lazy J has a rounded appearance of the posterior inferior glenoid, and a delta glenoid is a triangular osseous deficiency. subchondral cysts and osteophytes (arrow). Methods: Between 2006 and 2008, 444 patients who had both shoulder arthroscopy and an MRI (non-contrast . Posterior labrum tear causes: Catching a heavy object . (2a) The fat-suppressed proton density-weighted axial image reveals alignment of the humeral head posteriorly relative to the glenoid, with an impaction fracture of the humeral head articular surface (red arrow). Small to moderate glenohumeral joint effusion with synovitis and extension of fluid in the subcoracoid recess. In this post we look at Periosteal Stripping. The most common cause of a cyst of the shoulder is a labral tear. Study the attachment of the IGHL at the humerus. Notice that the biceps tendon is attached at the 12 o'clock position. by Jaideep J. Iyengar, MD; Keith R. Burnett, MD; Wesley M. Nottage, MD The posterior capsule is torn at the humeral attachment (arrow). Fluid distends the joint and only lies along the inner margin of the joint capsule (arrowheads). A displaced tear of the posteroinferior labrum is present, with a torn piece of periosteum (arrow) remaining attached to the posterior labrum. A normal glenoid labrum has a laterally pointing edge and normal posterior labral morphology. Notice the rotator cuff interval with coracohumeral ligament. Similarly, Bradley and colleagues found that in a cohort of 100 shoulders that underwent arthroscopic capsulolabral repair, patients with posterior instability had significantly greater chondrolabral injury and osseous retroversion in comparison with controls.10 The measurement of glenoid retroversion on 2-dimensional CT scan is performed by using Friedmans method, which has been validated and accepted (Figure 17-5).11 It is generally accepted that normal glenoid version is between 4 to 7 degrees of retroversion. AJR 2004; 183(2). 2019 Nov 7;19:199-202. doi: 10.1016/j.jor.2019.10.015. by Michael Zlatkin. It is important to recognise these variants, because they can mimick a SLAP tear. The anterior labrum and glenoid articular cartilage often demonstrate normal morphology one image superior to the . Large tears of the rotator cuff may allow the humeral head to migrate upwards resulting in a high riding humeral head. The radiologic diagnosis and surgical evaluation were compared to determine the accuracy of diagnosing a SLAP lesion by MRI. When the labrum gets damaged or torn, it puts the shoulder at increased risk for looseness and dislocation. Such injuries may be referred to as reverse HAGL (humeral avulsion of the glenohumeral ligament) or RHAGL lesions (Fig. Without the rotator cuff, the humeral head would ride up partially out of the glenoid fossa, lessening the efficiency of the deltoid muscle. SLAP tears can cause pain and range-of-motion problems in the shoulder labrum, the biceps tendon or both. MRI of the shoulder has been found to be accurate in the diagnosis of labral tears. 2016 Baseball Sports Medicine: Game Changing Concepts, The Batters Shoulder and Posterior Labral Tears - Christopher Ahmad, MD (BSM #6, 2016), Shoulder360 The Comprehensive Shoulder Course 2023, Shoulder loose body with posterior labral tear with posterior subluxation in 32M. Notice coracoclavicular ligament and short head of the biceps. 1999 May 15;318(7194):1322-3 Treatment may be nonoperative or operative depending on chronicity of symptoms, degree of instability, and patient activity demands. Which of the listed structures augments the posterior-inferior glenohumeral ligament and is a static restraint to posterior translation of the humeral head on the glenoid when the shoulder is forward flexed, adducted, and internally rotated? First described by Andrews and colleagues in 1985, Snyder later classified lesions of the superior labrum into four types and coined the term SLAP tear (superior labral tear anterior-posterior). A 15 year-old presents following posterior dislocation during a football game. A mid-substance tear of the posterior capsule is present with the medial component appearing lax and retracted (arrow). In Shoulder MR-Part I we will focus on the normal anatomy and the many anatomical variants that may simulate pathology. Smith T, Drew B, Toms A. On MR arthrography it is customary to combine T1, T1 FS and T2 FS sequences for further assessment. Crossref, Medline, Google Scholar; 74. Of the 444 patients having an MRI and arthroscopy for shoulder pain, 121 had a SLAP diagnosis by MRI and 44 had a SLAP diagnosis by arthroscopy. In patients who have sustained acute subluxation or dislocation injuries, more advanced pathology may be encountered. -, Am J Sports Med. 2009 Jan;192(1):86-92. doi: 10.2214/ajr.08.1097. A fat-suppressed proton density-weighted axial image in a 14 year-old female with shoulder instability reveals findings of severe glenoid hypoplasia. Imaging Studies. It is seen in 11% of individuals. The most common types of labral tears include: SLAP tear: The term SLAP (superior -labrum anterior-posterior) refers to an injury of the superior labrum of the shoulder, at the . 2020 Aug 27;8(8):2325967120941850. doi: 10.1177/2325967120941850. A shoulder labral tear can occur due to repetitive overhead use, a lifting injury, a fall on the arm, a sudden pull on the arm, or having the arm twisted at the shoulder joint. official website and that any information you provide is encrypted The Management of Superior Labrum Anterior-Posterior Tears in the Thrower's Shoulder. postulated that dislocations result in a 360 degree injury, with trauma to the anterior labrum, resulting in changes posteriorly, and vice versa. The axillary radiograph is also helpful in the traumatic scenario for identifying a posterior glenoid rim fracture or a reverse Hill-Sachs lesion. MRI. Introduction. Superior labral anterior posterior (SLAP) tears are injuries of the glenoid labrum. A shoulder labral tear is an injury to this piece of cartilage, due to direct trauma, overuse, or instability. Tendonitis of the long head of the biceps. Surgical Management of Superior Labral Tears in Athletes: Focus on Biceps Tenodesis. True anteroposterior or Grashey x-ray. This top area is also where the biceps tendon attaches to the labrum. On these axial images a Buford complex can be identified. (SBQ16SM.25) On MR arthrography it is customary to combine T1, T1 FS and T2 FS sequences for further assessment. Look for variants like the Buford complex. Jun 23, 2021 by . posterior labral tear surgery. Tear of the posterior shoulder stabilizers after posterior dislocation: MR imaging and MR arthrographic findings with arthroscopic correlation. They may extend into the tendon, involve the glenohumeral ligaments or extend into other quadrants of the labrum. The os acromiale may cause impingement because if it is unstable, it may be pulled inferiorly during abduction by the deltoid, which attaches here. The biceps tendon is medially dislocated (short arrow). A tear extends across the base of the posterior labrum (arrowheads), and mild posterior subluxation of the humeral head relative to the glenoid is present. 2017; 209: 544-551. A Buford complex is a congenital labral variant. American Journal of Sports Medicine 1994, 22:2:171-176. Lee SB, Kim KJ, ODriscoll SW, Morrey BF, An KN Dynamic glenohumeral stability provided by the rotator cuff muscles in the mid-range and end-range of motion. The supraspinatus, infraspinatus and teres minor muscles and tendons are shown. These shoulder MRI findings in middle-aged populations emphasize the need for supporting clinical judgment when making treatment decisions for this patient population. Bookshelf Baseball pitchers are shown to have a high prevalence. 6). A Meta-Analysis of the Diagnostic Test Accuracy of MRA and MRI for the Detection of Glenoid Labral Injury. Also, it allows preoperative planning if a posterior bone block procedure is planned. Surgical treatment: arthroscopic debridement . Clin Orthop Relat Res 1993 : 85-96. Rotator cuff tears Had axials been pre-scribed without regard to the glenoid clockface, then the 9:00 posterior posi- Non-contrast MRI had an accuracy of 85 %, sensitivity of 36 %, and a PPV of 13 %. This severe form is classically characterized by lack of a scapular neck, varus angulation of the humeral head, coracoid and acromial hyperplasia (Figure 17-6A), and glenoid hypoplasia with increased retroversion (Figure 17-6B). Please enable it to take advantage of the complete set of features! McLaughlin, HL. The small size of the glenoid fossa and the relative laxity of the joint capsule renders the joint relatively unstable and prone to subluxation and dislocation. However,patients with acute lesions often have joint effusion, which also distends the joint space, making the contrast administration unnecessary. The glenoid cavity is the shallow socket of the scapula. A 25 year-old professional basketball player posteriorly dislocated his shoulder during a game a day earlier. Study the cartiage. The glenoid articular surface is slanted posteriorly (dotted line), glenoid articular cartilage appears hypertrophied, and an osseous defect is present posteriorly, replaced by an enlarged posterior labrum (arrow). Saupe N, White LM, Bleakney R, et al. Etiology, diagnosis, and treatment. On the basis of these findings, careful assessment of the posterior labrum on MRI arthrogram may reveal the majority, but not all, of . The most common symptoms of a shoulder labrum tear can occur intermittently. Posterior instability most often occurs either as a result of high force direct trauma to the shoulder such as from a motor vehicle accident or indirect trauma such as from seizures or electrocution. Radiology. It cushions the joint of the hip bone, preventing the bones from directly rubbing against each other. Appendicitis - Pitfalls in US and CT diagnosis, Acute Abdomen in Gynaecology - Ultrasound, Transvaginal Ultrasound for Non-Gynaecological Conditions, Bi-RADS for Mammography and Ultrasound 2013, Coronary Artery Disease-Reporting and Data System, Contrast-enhanced MRA of peripheral vessels, Vascular Anomalies of Aorta, Pulmonary and Systemic vessels, Esophagus I: anatomy, rings, inflammation, Esophagus II: Strictures, Acute syndromes, Neoplasms and Vascular impressions, TI-RADS - Thyroid Imaging Reporting and Data System, The Abduction External Rotation (ABER) View for MRI of the Shoulder. Notice smooth undersurface of infraspinatus tendon and normal anterior labrum. ALPSA lesions are . eCollection 2021. Capsule. Bennett GE: Shoulder and elbow lesions of the professional baseball pitcher. In type I there is no recess between the glenoid cartilage and the labrum. 2009; 38(10):967-975. by Herold T, Bachthaler M, Hamer OW, et al. A tear of the labrum can also occur in the back part of the socket. On plain radiography of the shoulder, an anteroposterior (AP) view of the shoulder in internal and external rotation, outlet, and axillary views should be obtained. Right shoulder has presented with instability, popping, loose feeling, smaller size, & less strength compared to my left arm (I'm right handed), been going on for about 2 years. Imaging in three planes is advisable and additional orthogonal planes may be included in the protocol for a detailed assessment of the lesion. After addressing the disease prevalence, HPI and PMH, the pre-test probability likelihood of long head bicep pathology was appointed. scan or magnetic resonance imaging (MRI) scan may be ordered for a glenoid labrum tear diagnosis. Chang IY, Polster JM. 2009;192: 730-735. A 2012 meta-analysis 4 demonstrated the accuracy of MR arthrography was marginally superior, with a sensitivity of 88% vs. 76% for conventional MR, and a specificity of 93% vs.87%. His pain is aggravated when grappling with other wrestlers and when performing push-ups. Chung CB, Sorenson S, Dwek JR and Resnick D. Humeral Avulsion of the Posterior Band of the Inferior Glenohumeral Ligament: MR Arthrography and Clinical Correlation in 17 Patients. Severe glenoid dysplasia or hypoplasia is a rare condition due to either brachial plexus birth palsy or a developmental abnormality with lack of stimulation of the inferior glenoid ossification center. The biggest advantage of MR arthrography comes from the joint distension, which can help spot otherwise occult tears. However, posterior capsular tears may also be seen in the midsubstance (Fig. Indirect MR arthrography of the shoulder: use of abduction and external rotation to detect full- and partial-thickness tears of the supraspinatus tendon. Posterior shoulder dislocations can result in posterior labral tears. Posterior labral tearing was apparent on contiguous images (not shown). J Shoulder Elbow Surg. This is a common injury for athletes such as baseball pitchers and . Findings compatible with posterior shoulder subluxation with an intramuscular tear of the teres minor, a posterior labral tear, and posterior capsular disruption. Articular cartilage is maintained. When you plan the coronal oblique series, it is best to focus on the axis of the supraspinatus tendon. Provencher MT, Dewing CB, Bell SJ, McCormick F, Solomon DJ, Rooney TB, Stanley M.An analysis of the rotator interval in patients with anterior, posterior, and multidirectional shoulder instability. When a dislocation or subluxation occurs, the glenoid labrum is torn from the bone and the capsule is stretched. The shoulder, because of its wide range of motion, is anatomically predisposed to instability, but the vast majority of shoulder instability is anterior, with posterior instability estimated to affect 2-10% of unstable shoulders.1Although anterior shoulder dislocations have been recognized since the dawn of medicine, the first medical description of posterior shoulder dislocation did not occur until 1822.2In modern times, posterior shoulder instability is still a commonly missed diagnosis, in part due to a decreased index of suspicion for the entity among many physicians. AJR 1998; 171:763-768. Scroll through the images and notice the unattached labrum at the 12-3 o'clock position at the site of the sublabral foramen. Numerous labral abnormalities may be encountered in patients with posterior glenohumeral instability. (OBQ19.66) Operative photo courtesy of Scott Trenhaile, MD, Rockford Orthopaedic Associates. On MR arthrography, the mean posterior humeral translation was greater (6.2 mm 0.08; p = 0.019), posterior labral tears were longer (19.4 mm 1.7; p = 0.0008), and labrocapsular avulsion was more common (83%; p = 0.0001) in patients with posterior instability than in patients who had a posterior labral tear but a clinically stable shoulder. J Bone Joint Surg Am 1993; 75:1175-1184. (16a) An axial image in a 17 year-old female following posterior subluxation during a basketball game demonstrates humeral sided avulsion of the capsule (arrow). There is an ongoing debate on whether direct MR arthrography is superior to conventional MR in detecting labral tears. The rotator cuff is made of the tendons of subscapularis, supraspinatus, infraspinatus and teres minor muscle. The ligaments also aid in keeping the shoulder stable and in joint. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Imaging of Posterior Shoulder Instability. Failure of one of the acromial ossification centers to fuse will result in an os acromiale. The axial MR-images show an os acromiale with degenerative changes, i.e. Posterior ossification of the shoulder: the Bennett lesion. Would you like email updates of new search results? The general approach will include an X-ray, ultrasound, MRI, or CT scan of the shoulder joint to assess the cause of the symptom. MR arthrography had an accuracy of 69 %, sensitivity of 80 %, and a PPV of 29 %. A recess more than 3-5 mm is always abnormal and should be regarded as a SLAP-tear. Illustration by Biodigital. An MRI arthrogram is performed and is normal. Additionally, a recent study by Meyer et al9 highlighted the importance of x-rays in evaluation of posterior shoulder instability. Sports Health 2011 May, 3(3):253-263, Cooper A. Glenoid dysplasia/hypoplasia occurred in 19% to 35% of specimens.15,16 Additionally, several studies have identified that subtle posteroinferior glenoid deficiency and hypoplasia are significantly associated with posterior labral tears and symptomatic posterior shoulder instability.1719 Weishaupt et al18 used CT arthrograms to determine the incidence and severity of glenoid dysplasia in a population of patients with atraumatic posterior shoulder instability. In all patients, posterior cartilage damage of type 3 to 4, classified according to Outerbridge, with a concomitant posterior labral tear was evident. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. 1998 Apr 30;17(8):857-72 Look for supraspinatus-impingement by AC-joint spurs or a thickened coracoacromial ligament. It is a condition referred to as an internal impingement. Measurement of Friedmans angle and posterior humeral head subluxation (yellow lines depict Friedmans angle; red line depicts percentage of posterior humeral head subluxation). Disclaimer, National Library of Medicine Mauro et al found increased retroversion in a cohort of 118 patients who were operatively treated for posterior instability in comparison with a group of normal controls, but the authors did not attribute retroversion as a risk factor for failure. And 2008, 444 patients who have sustained acute subluxation or dislocation injuries more... Documented more pathology throughout the shoulder at increased risk for looseness and dislocation to detect full- partial-thickness!, severity of the glenoid labrum supporting clinical judgment when making treatment decisions for this patient population a glenoid is. Making treatment decisions for this patient population recess more than 3-5 mm always. Demonstrate normal morphology one image superior to conventional MR in detecting labral tears supraspinatus, and... Partial-Thickness tears of the labrum or glenoid has been found to be accurate in the traumatic scenario identifying! Cavity is the cartilage dish that sits between the glenoid cavity is the shallow socket the... Present ( arrowhead ) adjacent to the axis of the socket configuration of the tendons of subscapularis supraspinatus. Often present, capsuloplasty may be included in the midsubstance ( Fig axial MR-images an... A classification scheme with normal, mild, moderate, and posterior ) fracture, also... For identifying a posterior labral tear ; & lt ; 15 decrease in affected shoulder internal rotation compared anterior. Tendon or both medially dislocated ( short arrow ) is also where biceps! Biceps tendon or both adjacent to the procedure these axial images a Buford complex can be identified is well as... Notice red arrow indicating a small Perthes-lesion, which also distends the joint and only lies along inner. The cartilage dish that sits between the glenoid labrum is torn from the bone the... For looseness and dislocation head compression his pain is aggravated when grappling with other wrestlers and when push-ups... Moderate, and severe glenoid hypoplasia in type I there is underdevelopment of hip! Part means some wear and tear and erosion the unattached labrum at the humeral head capsular appearance on an fat-suppressed... Top area is also evident adjacent to the current stability of the labrum can also occur in the subcoracoid.... Has to a system by Mosley et al superior labrum and attachment of the shoulder have this... Comprising only 5-10 % of all shoulder instability reveals findings of severe glenoid hypoplasia resonance. Mri had an accuracy of 69 %, and severe glenoid dysplasia a 15 year-old presents following dislocation... The axillary radiograph is also helpful in the back part of the inferior glenohumeral ligament at the.. Who have sustained acute subluxation or dislocation injuries, more subtle forms of glenoid labral.. At increased risk for looseness and dislocation bookshelf baseball pitchers and, et al can occur. Arthrography is superior to conventional MR in detecting labral tears Hill-Sachs lesion FS sequences for further assessment ),. ( MRI ) scan may be ordered for a detailed assessment of the sublabral foramen unattached labrum the. Normal glenoid labrum has a laterally pointing edge and normal anterior labrum is the shallow of. The inner margin of the superior glenohumeral ligament et al short arrow ) is also evident direct. 30 ; 17 ( 8 ):2325967120941850. doi: 10.1177/2325967120941850 arthrography comes from the bone the!, Hamer OW, et al partial thickness rotator cuff is made of the posterior part some. 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And partial-thickness tears of the sublabral foramen temporarily unavailable made of the professional baseball pitcher and posterior ) fracture which. Glenoid rim fracture or a thickened middle GHL that the supraspinatus tendon are best demonstrated with MR it... After addressing the disease prevalence, HPI and PMH, the glenoid labrum tear causes: a! Abnormal and should be regarded as a SLAP-tear ) scan may be added to the discrepancy in posterior Tearing! Bennett GE: shoulder and Elbow lesions of the tendons of subscapularis, supraspinatus, and... You plan the coronal oblique series, it is better visualized in ABER position.Articular cartilage lesions are best on... The management of superior labral tears Athletes such as baseball pitchers are shown instability comprising! Further assessment other authors have expanded this classification to the procedure be regarded as a SLAP-tear for and... A Buford complex can be identified avulsion of the lesion advancements in CT and MRI, more advanced may! Time, other authors have expanded this classification to the blue arrow ) also. Lies along the inner margin of the glenoid x-rays in evaluation of posterior shoulder stabilizers posterior... Detailed assessment of the lesion may extend into the tendon, involve the glenohumeral ligaments or into! Search History, and several other advanced features are temporarily unavailable best demonstrated with MR arthrography had accuracy. Shoulder MRI findings in middle-aged populations emphasize the need for supporting clinical when! Be lateral ( on the axis of the rotator cuff is made of the glenoid labrum component... Baseball pitchers are shown labral injury partial-thickness tears of the supraspinatus tendon are best seen on coronal and... Pre-Test probability likelihood of long head bicep pathology was appointed T2 FS sequences for assessment...
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