Role of MR arthrography In Assessment of Glenohumeral Instability

Aly, Hamdan Abdelhameed; Alkousy, Mohammad Hassan; Zaky, Khaled Fawzy; Solyman, Mohammad Tharwat Mahmoud

doi:10.21608/svuijm.2021.96089.1221

Role of MR arthrography In Assessment of Glenohumeral Instability

Document Type : Original research articles

Authors

Department of Radio-diagnosis, Faculty of Medicine, Sohag University, Sohag, Egypt

10.21608/svuijm.2021.96089.1221

Abstract

Background: The glenohumeral joint has a unique structure which allows for the widest range of motion among all joints in the human body; however this unfortunately makes the joint inherently unstable. Various imaging techniques are available for assessment of shoulder joint abnormalities. Magnetic resonance arthrography is considered the best modality for the assessment of disorders related to shoulder instability. The injection of para magnetic contrast solution into the joint cavity induced distension of the capsule allowing separation of the intra articular structures and beret visualization of shoulder disorders. However, arthrography is a time-consuming, minimally invasive procedure, which, although generally safe, it might carries some risks like hemorrhage and infection.
Objectives: The aim of this work was to evaluate the diagnostic performance of MR arthrography (MRA) in the detection of shoulder disorders in patients having shoulder instability.
Patients and methods: Between February 2017 and March 2021, 50 patients with a clinical diagnosis of shoulder instability were examined by MR arthrography. MR arthrographic finings including the different labral tears, rotator-cuff tears (RCTs) and Hill–Sachs lesions were recognized and compared to surgical arthroscope ‘ the gold standard’. Sensitivity, specificity, accuracy, PPV and NPV were calculated for MR arthrography.
Results: MRA showed sensitivity and specificity of about 90% for the detection of classic Bankart lesions, sensitivity of 91.8 and specificity of 100%, for detecting bony Bankart lesions, sensitivity and specificity of 91.6 %, and 100% for the detection of SLAP lesions. The sensitivity and specificity for the detection of Hill-Sachs were 92.31%, 100% respectively; the sensitivity and specificity in the detection of RCTs were 95.24% and 100%.
Conclusion: MR arthrography has a high diagnostic performance in the detection of different labral tears. RCTs (in particular partial thickness RCTs) and Hill–Sachs lesions.

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