title: Agreement between magnetic resonance imaging and arthroscopic evaluation of the shoulder joint in primary anterior dislocation of the shoulder.
abstract: OBJECTIVE
  To determine the effectiveness of magnetic resonance imaging in identifying shoulder pathology in patients with primary traumatic dislocation of the shoulder and to compare these findings with findings at the time of arthroscopic surgery.
  
  
  METHODS
  Correlation between arthroscopy and magnetic resonance imaging.
  
  
  METHODS
  Sixteen patients, aged 18 to 30 years, who were randomized to the surgical arm of a study comparing the effectiveness of immediate arthroscopic surgery with immobilization and rehabilitation for primary traumatic anterior dislocation of the shoulder, were included in this study.
  
  
  METHODS
  Each patient underwent magnetic resonance imaging and a videotaped "tour" of the shoulder prior to any surgical intervention.
  
  
  METHODS
  Magnetic resonance scans and videotapes were reviewed for the presence or absence of abnormalities in 8 features of the shoulder, and concordant and discordant findings were evaluated.
  
  
  RESULTS
  There was moderate correlation for superior labral lesions (kappa = 0.60) and fair agreement for rotator cuff tear (kappa = 0.355). When the joint capsule was assessed, there was only fair agreement for both the presence of an abnormality (kappa = 0.310) and redundancy and tear (kappa = 0.394). Both methods were sensitive for the detection of Hill-Sachs lesions (kappa = 1.0), although there was only moderate agreement (kappa = 0.44) on estimation of size. There was perfect agreement for the detection of Bankart lesions or equivalent capsulolabral disruption (kappa = 1.0).
  
  
  CONCLUSIONS
  Magnetic resonance imaging can be considered a valuable tool for the detection of Hill-Sachs and Bankart lesions associated with primary traumatic anterior dislocations of the shoulder. Its ability to detect other pathologic lesions, however, is limited.
authors.affiliation: Fowler Kennedy Sport Medicine Clinic, London, Ontario, Canada.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kirkley
authors.forename: Robert
authors.initials: R
authors.lastname: Litchfield
authors.forename: Lisa
authors.initials: L
authors.lastname: Thain
authors.forename: Alison
authors.initials: A
authors.lastname: Spouge
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000293:injuries / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D017006:Rotator Cuff / Q000473:pathology; D000070636:Rotator Cuff Injuries; D012783:Shoulder Dislocation / Q000175:diagnosis*