title: SHART: shoulder hyperabduction radiological test.
abstract: OBJECTIVE
  To evaluate and quantify laxity of the inferior glenohumeral ligament (IGHL) in post-traumatic anterior instability of the shoulder with the shoulder hyperabduction radiological test (SHART) and correlate it with arthroscopic findings.
  
  
  METHODS
  This prospective study included 21 patients undergoing arthroscopic stabilization for anteroinferior shoulder instability. The SHART test was performed as follows: a bilateral AP radiograph was performed in the supine position, and radiographs were compared. The shoulder was positioned in passive maximum abduction in neutral rotation, and neither general nor regional anesthesia was used. The angle between the axis of the humeral shaft and the line drawn between the lateral border of the scapular tubercle and the inferior edge of the glenoid fossa was measured. During arthroscopy, IGHL distension was classified into 4 stages according to the Detrisac classification. Extensive distension was considered to be the stages 3 and 4.
  
  
  RESULTS
  The correlation between the SHART test and Detrisac staging was found to be statistically significant (P = 0.02). In the presence of a difference of more than 15° between the pathological and the contralateral shoulder on radiographs, the SHART test shows 87% of IGHL distension, Detrisac stages 3 and 4.
  
  
  CONCLUSIONS
  We suggest that the SHART test should be added to conventional preoperative imaging tests for anterior instability.
authors.affiliation: Orthopaedic Surgery Department, Ambroise Paré Hospital, 9 avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Jouve
authors.forename: Charles
authors.initials: C
authors.lastname: Schlur
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Klouche
authors.forename: Thomas
authors.initials: T
authors.lastname: Bauer
authors.forename: Benoit
authors.initials: B
authors.lastname: Rousselin
authors.forename: Philippe
authors.initials: P
authors.lastname: Hardy
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D008023:Ligaments, Articular / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D018709:Statistics, Nonparametric; D016683:Supine Position