title: Magnetic resonance arthrography assessment of the superior labrum using the BLC system: age-related changes mimicking SLAP-2 lesions.
abstract: OBJECTIVE
  The purpose of the study was to describe the variation of the superior labrum with increasing age by assessing magnetic resonance (MR) arthrograms.
  
  
  METHODS
  Inclusion criteria were used to include only the MR arthrograms of patients devoid of clinical labral pathology. Two hundred thiry-six MR arthrograms were blindly assessed for biceps-labral complex (BLC) type 1-3 and sublabral recess size by a musculoskeletal radiologist. We have chosen the BLC system, which defines normal superior labral variants, since it is established in the literature and is used by reporting musculoskeletal (MSK) radiologists.
  
  
  RESULTS
  The MR arthrograms demonstrated that the majority of patients <40 years old were BLC type 1 and showed a steady increase in BLC types 2 and 3 with increasing age. Assessments demonstrated significantly greater (p < 0.01) mean BLC types (1.62 vs 1.29) and recess size (1.35 vs 0.66 mm) in those over 40 compared with those less than 40 years of age. Furthermore, significant differences (p < 0.05) were noted between mean BLC assessments between different decades of age.
  
  
  CONCLUSIONS
  There appears to be a physiologic deepening of the superior labrum sulcus with age, which becomes significant after the age of 40. These findings can contribute to whether the superior labrum is considered abnormal when assessed radiographically. The differentiation of normal age-related changes in the shoulder, from those of a type 2 SLAP tear can reduce the rates of unnecessary SLAP-2 repairs. This is the first reported series to use the BLC system; we believe it provides a common nomenclature to allow clear communication between specialists.
authors.affiliation: Queen's School of Medicine, Kingston, Ontario, Canada.
authors.forename: Adrian
authors.initials: A
authors.lastname: Koziak
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Chuang
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Jancosko
authors.forename: Keith R
authors.initials: KR
authors.lastname: Burnett
authors.forename: Wesley M
authors.initials: WM
authors.lastname: Nottage
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D000704:Analysis of Variance; D001175:Arthrography / Q000379:methods*; D002648:Child; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000033:anatomy & histology* / Q000473:pathology*; D055815:Young Adult
chemical_list: D003287:Contrast Media
references.citation: J Bone Joint Surg Am. 1990 Oct;72(9):1344-8
references.pmid: 2229110
references.citation: AJR Am J Roentgenol. 2006 Oct;187(4):887-93
references.pmid: 16985130
references.citation: Surg Radiol Anat. 2005 Dec;27(5):385-8
references.pmid: 16136274
references.citation: Arthroscopy. 1994 Jun;10(3):241-7
references.pmid: 8086014
references.citation: Orthopade. 2003 Jul;32(7):586-94
references.pmid: 12883757
references.citation: J Digit Imaging. 2007 Jun;20(2):122-30
references.pmid: 17333414
references.citation: AJR Am J Roentgenol. 1998 Jul;171(1):235-8
references.pmid: 9648795
references.citation: AJR Am J Roentgenol. 2008 Sep;191(3):W96-9
references.pmid: 18716085
references.citation: Eur Radiol. 2010 Mar;20(3):666-73
references.pmid: 19727741
references.citation: AJR Am J Roentgenol. 1995 Jan;164(1):141-6
references.pmid: 7998527
references.citation: Radiol Clin North Am. 1997 Jan;35(1):97-116
references.pmid: 8998211
references.citation: Skeletal Radiol. 1993 Oct;22(7):507-10
references.pmid: 8272886
references.citation: Radiology. 1996 Oct;201(1):251-6
references.pmid: 8816553
references.citation: AJR Am J Roentgenol. 2004 May;182(5):1271-8
references.pmid: 15100131
references.citation: Am J Sports Med. 2004 Jun;32(4):962-6
references.pmid: 15150044
references.citation: Am J Sports Med. 2012 Jul;40(7):1538-43
references.pmid: 22628153
references.citation: J Shoulder Elbow Surg. 2003 Jan-Feb;12(1):40-52
references.pmid: 12610485
references.citation: Eur J Radiol. 2008 Oct;68(1):72-87
references.pmid: 18499376
references.citation: Eur Radiol. 2006 Feb;16(2):451-8
references.pmid: 16047149
references.citation: AJR Am J Roentgenol. 1992 Oct;159(4):787-92
references.pmid: 1529844
references.citation: Arthroscopy. 1990;6(4):274-9
references.pmid: 2264894