Capsulo-labro-ligamentous lesions of the shoulder: evaluation with MR arthrography.
OBJECTIVE
The aim of the study was to analyse the accuracy of MR arthrography in the evaluation of capsulo-labro-ligamentous lesions of the shoulder in patients with glenohumeral joint instability.


METHODS
From 1999 to 2001 fifty-eight patients with glenohumeral joint instability were studied by MR arthrography. Twenty-seven patients underwent surgical repair: 11 by arthroscopic and 16 by arthrotomic approach. All shoulder evaluations were performed with T1 and T2 weighted axial, coronal and sagittal oblique images, before and after intra-articular injection of gadolinium contrast.


RESULTS
Forty capsulo-ligamentous lesions (including 14 capsular ruptures with extravasation of the contrast medium) were detected by MR arthrography. Fifty-two labral tears (36 of the anterior, 13 of the superior and 3 of the posterior glenoid labrum) were identified: 11 out of 52 were not recognized before gadolinium contrast injection. Five rotator cuff tears were identified, one of which was not shown in the pre-injection examination. Surgical results confirmed the MR arthrographic findings in 25/27 patients. In one case MR arthrography did not recognize a SLAP lesion; in another case it identified a tear of the capsule but not of the glenoid labrum.


CONCLUSIONS
In many cases of subacute glenohumeral joint lesions with intracapsular fluid, MR may accurately evaluate capsulo-labral-ligamentous lesions. Indeed, the examination of lesions is limited by the absence of the natural contrast determined by fluid; in such cases, intra-articular injection of gadolinium contrast is necessary. MR arthrography evaluates the degree of capsulo-labro-ligamentous tears and may guide the surgical approach.
Volpi
Davide
D
UO di Radiologia, Presidio Ospedaliero Cremonese, Istituti Ospedalieri di Cremona, Cremona, Italy.
Olivetti
Lucio
L
Budassi
Piero
P
Genovese
Eugenio
E
D000293:Adolescent; D000328:Adult; D001175:Arthrography; D003287:Contrast Media; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery
D003287:Contrast Media