[Shoulder instability and pain. Computerized arthro-tomography assessment].
The growing interest in shoulder joint imaging comes from the ever-increasing demand for such an examination in orthopedics. Since more complete and detailed imaging of bone, capsuloligamentous and musculotendinous compartments is always needed, CT arthrography has necessarily become a widely used method. In this study, 282 patients were investigated with CT arthrography. Seventy per cent of them had anatomical instability, 17.3% had functional instability and the extant 12.7% had shoulder pain. In traumatic instability, the most often injured structures were the glenoid labra (91%) and the capsule (82%). Lesions in the two structures were nearly always associated. Moreover, high incidence (65.8%) of Hill-Sachs lesions of the humeral head was observed. In atraumatic instability, abnormal anteversion of the scapular glenoid was always detected. In the patients with shoulder pain, the most common causes were the impingement syndrome (30.5%), superior labrum lesions (16.7%), adhesive capsulitis (16.7%) and synovial osteochondromatosis (13.7%). With CT arthrography, labial abnormalities (detachments, tears, amputations, eversions and degeneration) can be identified, as well as capsular lesions (insertional detachment and laxity), rotator cuff conditions (bursitis, tendinitis and partial/complete tears), biceps tendon abnormalities and glenoid rim and humeral head fractures. Moreover, CT arthrography is minimally invasive and well tolerated. It exhibits 97.7% specificity, 91% sensitivity and 96% accuracy. Furthermore, it has been proven to be extremely useful in treatment and surgical planning.
Pricca
P
P
Servizio di Radiodiagnostica, IRCCS Policlinico S. Matteo, Pavia.
Cecchini
A
A
Petullà
M
M
Benazzo
F
F
Poggi
P
P
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging*; D013710:Tendons / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
Spalla instabile e dolorosa. Valutazione con artro-tomografia computerizzata.