title: Moderate value of non-contrast magnetic resonance imaging after non-dislocating shoulder trauma.
abstract: OBJECTIVE
  The purpose of the present study was to determine the value of shoulder magnetic resonance imaging (MRI) obtained in the community setting interpreted by musculoskeletal radiologists in patients with shoulder pain initiated by a single non-dislocating shoulder trauma.
  
  
  METHODS
  In 56 of 61 consecutive patients who underwent shoulder arthroscopy due to pain after a single non-dislocating shoulder trauma, the data sets of non-contrast MRI were complete. These were retrospectively interpreted by three radiologists specialized on musculoskeletal MRI who were blinded for patients' history and who did not have access to the reports of arthroscopy. Standard evaluation forms were used to assess the MRIs for superior labrum anterior and posterior (SLAP) lesions, anterior or posterior labrum lesions, lesions of the long head of biceps tendon (LHB) and for partial tears of the supraspinatus tendon and the upper quarter of the subscapularis tendon. Quality of the MRI was assessed by each radiologist on a four-point scale.
  
  
  RESULTS
  The pooled sensitivity for the three radiologists for the detection of SLAP lesions was 45.0 %, for anterior or posterior labrum tears 77.8 and 66.7 %, for lesions of the LHB 63.2 % and for partial tears of the supraspinatus or subscapularis tendon tears 84.8 and 33.3 %. Corresponding inter-rater reliabilities were poor (SLAP lesions) to substantial (anterior labrum tears). Quality of MRI only influenced the accuracy for the detection of posterior labrum tears.
  
  
  CONCLUSIONS
  A non-contrast shoulder MRI obtained in the community setting after non-dislocating shoulder trauma has a moderate sensitivity for most intraarticular pathologies when interpreted by musculoskeletal radiologists. Accuracy is dependent on the observer and not on the assessed quality.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Health - School of Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Ostmerheimerstr. 200, 51109, Cologne, Germany. marc.banerjee@gmx.de.
authors.forename: Marc
authors.initials: M
authors.lastname: Banerjee
authors.affiliation: Praxis im KölnTriangle, Cologne, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Müller-Hübenthal
authors.affiliation: Mediapark Klinik, Cologne, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Grimme
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Health - School of Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Ostmerheimerstr. 200, 51109, Cologne, Germany.
authors.forename: Maurice
authors.initials: M
authors.lastname: Balke
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Health - School of Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Ostmerheimerstr. 200, 51109, Cologne, Germany.
authors.forename: Bertil
authors.initials: B
authors.lastname: Bouillon
authors.affiliation: Cologne Merheim Medical Center, IFOM, Institute for Research in Operative Medicine, University of Witten/Herdecke, Cologne, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.affiliation: Department of Radiology, Cologne Merheim Medical Center, University of Witten/Herdecke, Cologne, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Goßmann
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Health - School of Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Ostmerheimerstr. 200, 51109, Cologne, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Shafizadeh
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D012680:Sensitivity and Specificity; D012782:Shoulder; D000070599:Shoulder Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D020069:Shoulder Pain / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery
keywords: Posttraumatic shoulder pain; SLAP lesion; Shoulder MRI; Shoulder arthroscopy; Shoulder trauma