MR arthrogram for shoulder microinstability and hidden lesions

Peer review under responsibility of Alexandria University Faculty of Medicine.

Available online 1 May 2014

Abstract

Shoulder joint pain due to anterior microinstability is not an unusual complaint of young active individuals. Different etiologies of such shoulder microinstability are encountered, mainly affecting the anterior–inferior labro-ligamentous capsular structures. These injuries include Perthes lesion, ALPSA, GLAD, RIT, SLAP and glenohumeral ligamentous injuries.

The aim of this study

The aim of this study is to enhance the role of MR arthrogram over routine MRI in the diagnosis of such subtle lesions.

Patients and methods

This is a prospective study, involving 30 consecutive patients of shoulder microinstability complaints, evaluated by MR arthrogram of the affected shoulder.

Results

Perthes lesions were diagnosed in 6 patients, ALPSA in 3 patients, GLAD in 2 patients, RIT in 2 patients and SLAP in 11 patients. Ligamentous injuries that include tear of MGHL, were found in 2 patients and IGHL in 4 patients.

Conclusion

MR arthrogram is highly recommended for the management of young patients with shoulder microinstability or unexplained painful movement complaints.

Abbreviations:

• ABER
• abduction external rotation
• AIOS
• Acquired Instability in Overstressed shoulder, surgery
• ALPSA
• anterior labral ligamentous periosteal sleeve avulsion
• AMSI
• Atraumatic Minor Shoulder Instability
• GLAD
• glenolabral articular disruption
• IGLI
• avulsion of inferior glenohumeral ligament
• MGL
• middle glenohumeral ligament
• RI
• rotator interval
• RIT
• rotator interval tear
• SLAP
• superior labrum anterior to posterior tear
• TUBS
• Traumatic, Unidirectional, Bankart lesion, responds to surgery

Keywords:

• Shoulder MR arthrogram
• Microinstability
• Perthes
• ALAPSA
• GLAD
• Rotator interval

Notes

Peer review under responsibility of Alexandria University Faculty of Medicine.

Available online 1 May 2014