title: MR shoulder arthrography in patients younger than 40 years of age: frequency of rotator cuff tear versus labroligamentous pathology.
abstract: The purpose of this study was to compare the frequency of rotator cuff pathology versus labroligamentous pathology in patients younger than 40 years and to determine whether routine MR arthrography is justified in all patients in this age group, regardless of the clinical symptoms. The MR arthrography was carried out on 332 patients 40 years of age and younger. Two hundred and forty-three patients had clinical history of instability and possible labroligamentous pathology. Eighty-nine patients had no history or physical signs of instability and were referred for reasons other than instability, such as assessment for rotator cuff tear. In the 243 patients younger than 40 years with clinical history of potential labral pathology, 39% (95/243) showed a labral tear and 2.1% (5/243) had a full-thickness rotator cuff tendon tear. In the 89 patients with no history suggesting labral pathology, 19% (17/89) showed an unsuspected labral tear and 4.5% (4/89) had a full-thickness rotator cuff tear. These findings suggest that, regardless of the clinical indication for referral, patients aged 40 and less referred for shoulder MRI should be imaged using MR arthrography because of the significant risk that symptoms are related to unsuspected labral pathology.
authors.affiliation: Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. kevinrowan@yahoo.com
authors.forename: K R
authors.initials: KR
authors.lastname: Rowan
authors.forename: G
authors.initials: G
authors.lastname: Andrews
authors.forename: A
authors.initials: A
authors.lastname: Spielmann
authors.forename: J
authors.initials: J
authors.lastname: Leith
authors.forename: B B
authors.initials: BB
authors.lastname: Forster
mesh_terms: D000293:Adolescent; D000328:Adult; D001175:Arthrography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007482:Iothalamate Meglumine; D007593:Joint Instability / Q000175:diagnosis*; D008023:Ligaments, Articular / Q000293:injuries* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D017006:Rotator Cuff / Q000473:pathology; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000473:pathology; D012965:Sodium Chloride / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride; C064925:gadodiamide; D019786:Gadolinium DTPA; D007482:Iothalamate Meglumine