Shoulder joint instability evaluation by CT arthrography and MR arthrography

Abstract Objectives The purpose of this agreement was to establish evidence-based consensus statements on imaging of scapholunate joint (SLJ) instability by an expert group using the Delphi technique. Methods Nineteen hand surgeons developed a preliminary list of questions on SLJ instability. Radiologists created statements based on the literature and the authors’ clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panellists consisted of twenty-seven musculoskeletal radiologists. The panellists scored their degree of agreement to each statement on an eleven-item numeric scale. Scores of ‘0’, ‘5’ and ‘10’ reflected complete disagreement, indeterminate agreement and complete agreement, respectively. Group consensus was defined as a score of ‘8’ or higher for 80% or more of the panellists. Results Ten of fifteen statements achieved group consensus in the second Delphi round. The remaining five statements achieved group consensus in the third Delphi round. It was agreed that dorsopalmar and lateral radiographs should be acquired as routine imaging work-up in patients with suspected SLJ instability. Radiographic stress views and dynamic fluoroscopy allow accurate diagnosis of dynamic SLJ instability. MR arthrography and CT arthrography are accurate for detecting scapholunate interosseous ligament tears and articular cartilage defects. Ultrasonography and MRI can delineate most extrinsic carpal ligaments, although validated scientific evidence on accurate differentiation between partially or completely torn or incompetent ligaments is not available. Conclusions Delphi-based agreements suggest that standardized radiographs, radiographic stress views, dynamic fluoroscopy, MR arthrography and CT arthrography are the most useful and accurate imaging techniques for the work-up of SLJ instability. Key Points • Dorsopalmar and lateral wrist radiographs remain the basic imaging modality for routine imaging work-up in patients with suspected scapholunate joint instability. • Radiographic stress views and dynamic fluoroscopy of the wrist allow accurate diagnosis of dynamic scapholunate joint instability. • Wrist MR arthrography and CT arthrography are accurate for determination of scapholunate interosseous ligament tears and cartilage defects.

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Assessment of the superior labrum of the shoulder joint with CT-arthrography and MR-arthrography: correlation with anatomical dissection

Surgical and Radiologic Anatomy ◽

10.1007/bf01628117 ◽

1998 ◽

Vol 20 (1) ◽

pp. 57-62 ◽

Cited By ~ 18

Author(s):

F. Bresler ◽

A. Blum ◽

M. Braun ◽

J. M. Simon ◽

M. Cossin ◽

...

Keyword(s):

Shoulder Joint ◽

Mr Arthrography ◽

Ct Arthrography ◽

Anatomical Dissection ◽

Superior Labrum

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Role of MRI Arthrography Compared to Conventional MRI in Assessment of Shoulder Joint Disorders

QJM ◽

10.1093/qjmed/hcaa068.012 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M A Nassef ◽

S A A Abdulrahim ◽

D A A M Eldesouki

Keyword(s):

Joint Instability ◽

Glenohumeral Joint ◽

Imaging Technique ◽

Mr Arthrography ◽

Contrast Injection ◽

Ct Guided ◽

Ct Arthrography ◽

Glenoid Labrum ◽

Conventional Mri

Abstract Glenohumeral joint instability is extremely common. With regard to primary anterior shoulder dislocations, the incidence is between 8.2 and 23.9 per 100 000 person-years, with an estimated prevalence of 1.7%. Many imaging methods, including arthrography, CT arthrography, MR arthrography, have been used to image the glenoid labrum and the associated structures of the capsular mechanism. The aim of the study is to prove MR arthrography is the preferred imaging technique for the investigation of patients with shoulder instability. MR arthrography reliably shows subtle lesions of the labroligamentous complex, providing information essential to the surgeon concerning the surgery or arthroscopic repair .Thirty Patients with clinically evident or suspected shoulder impingemint or glenohumeral instability.of both sexes were included , conventional MRI was performed for all patients followed by CT guided intraarticular contrast injection then MRI Arthrography images taken within thirty minutes. Data were collected, revised, coded and entered to the Statistical Package for Social Science (IBM SPSS) version 20.

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Imaging findings in the dominant shoulder of throwing athletes: comparison of radiography, arthrography, CT arthrography, and MR arthrography with arthroscopic correlation.

American Journal of Roentgenology ◽

10.2214/ajr.172.5.10227520 ◽

1999 ◽

Vol 172 (5) ◽

pp. 1371-1380 ◽

Cited By ~ 63

Author(s):

B Roger ◽

A Skaf ◽

A W Hooper ◽

N Lektrakul ◽

L Yeh ◽

...

Keyword(s):

Mr Arthrography ◽

Imaging Findings ◽

Ct Arthrography

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Ultrasonography and MR Arthrogram in detection of shoulder joint disorders

QJM ◽

10.1093/qjmed/hcab106.072 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Souad Elsayed Mohammed Mansour ◽

Mohammed Sobhi Hassan ◽

Mohammed Gamal Eldin Abdel Motelib

Keyword(s):

Rotator Cuff ◽

Shoulder Joint ◽

Shoulder Dislocation ◽

Mr Arthrography ◽

Golden Rule ◽

Supraspinatus Tendon ◽

Tendon Tear ◽

Diagnosis Classification

Abstract Purpose To know the role of Ultrasonography and MR Arthrogram in detection of shoulder joint disorders Methods and material Thirty patients with suspected shoulder joint disorders underwent US,MRI ,MR arthrography shoulder. Results All cases with ALAPSA, Bankert, reverse bankert, hillsachs, perthes and SLAP are diagnosed accurately by MR arthrography with sensitivity of (100%) in GLAD ,Supraspinatus tendenopathy ,Supraspinatus tendon tear and IGHL injury sensitivity was decreased to 75%,in cases of paraglenid cysts arthrography did not diagnose any of them as there are no communication between the cyst and the joint Conclusion MR arthrography shoulder has a golden rule in diagnosis ,classification of cases of shoulder dislocation ,SLAP injuries and rotator cuff impingement

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MRI, MR-arthrography and CT-arthrography

The Meniscus ◽

10.1007/978-3-642-02450-4_11 ◽

2010 ◽

pp. 77-90

Author(s):

W. C. J. Huysse ◽

K. L. Verstraete

Keyword(s):

Mr Arthrography ◽

Ct Arthrography

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Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint

British Journal of Radiology ◽

10.1259/bjr.20190886 ◽

2020 ◽

Vol 93 (1106) ◽

pp. 20190886

Author(s):

Hayri Ogul ◽

Nurmuhammet Tas ◽

Mutlu Ay ◽

Mehmet Kose ◽

Mecit Kantarci

Keyword(s):

Shoulder Joint ◽

Glenohumeral Joint ◽

Imaging Modality ◽

Mr Arthrography ◽

Labral Tear ◽

Labral Tears ◽

Significant Difference ◽

Arthroscopic Examination ◽

Synovial Folds ◽

Direct Mr Arthrography

Objective: To describe the posterior labral lesions and labrocapsular abnormalities of the shoulder on sonoarthrography and to compare these findings with MR arthrography results. Methods: 82 shoulders were initially evaluated with ultrasonography and MRI and then were examined with sonoarthrography and MR arthrography following intraarticular injection of diluted gadolinium solution. The ultrasonography images were prospectively evaluated for the presence of posterior labral tear, sublabral cleft, and posterior capsular abnormalities by two radiologists. The diagnostic accuracy of sonoarthrography in the detection of posterior labral tears and posterior labrocapsular variants was compared with that of MR arthrography. Results: In sonoarthrographic examinations of 82 shoulders, 5 and 6 posterior labral tears were identified by Observer 1 and 2, respectively. Moreover, 6 and 7 posterior sublabral clefts, and 2 and 3 posterior synovial folds were identified by Observer 1 and 2, respectively. All the 82 patients were examined with MR arthrography; however, only 14 patients underwent arthroscopic examination. No significant difference was found among the 82 patients with regard to age, gender, and the prevalence of posterior labral tear, posterior labral cleft, and posterior synovial fold (p > 0.05). Interobserver variability showed substantial agreement between the sonoarthrographic and MR arthrographic results of the posterior labrocapsular structures (κ = 0.71, p < 0.05). Conclusion: Posterior labral tears and posterior synovial folds of the shoulder joint can be evaluated non-invasively by sonoarthrography. Advances in knowledge: Variations and pathologies of posterior labrocapsular structures of the glenohumeral joint are relatively uncommon. Direct (MR) arthrography is the gold-standard imaging modality to evaluate of posterior labrocapsular abnormalities of the glenohumeral joint. Sonoarthrography of the glenohumeral joint may be utilized in clinical practice in patients with contraindications to (MRI).

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