Background and aim Shoulder joint injuries such as rotator cuff tears (RCTs), superior labral anterior to posterior (SLAP) lesions, and Bankart lesions are leading causes of chronic shoulder pain (CSP). Accurate imaging is essential for diagnosis and treatment planning. While conventional MRI is widely used, magnetic resonance arthrography (MRA) has been proposed to improve diagnostic accuracy, particularly for intra-articular pathologies. This study aimed to compare the diagnostic performance of MRA versus conventional MRI in detecting RCTs, SLAP lesions, Bankart lesions, and osteochondral defects in patients with CSP. Patients and methods In this study, 30 patients (26 males, four females; mean age 29.03±7.2 years) with suspected shoulder injuries underwent both conventional MRI and direct MRA. Two independent radiologists assessed the images for the presence of specific lesions. Diagnostic performance was evaluated using sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, with arthroscopy serving as the reference standard. Results MRA demonstrated superior sensitivity and specificity for SLAP lesions (95 and 100%) compared with MRI (56 and 94%). For RCTs, MRA showed 92.3% sensitivity and 100% specificity, outperforming MRI (80 and 100%). MRA also surpassed MRI in detecting Bankart lesions (81.8 vs. 30% sensitivity). Both modalities achieved 100% accuracy for osteochondral defects. Interobserver agreement was excellent, especially for SLAP lesions (κ=0.82). Conclusion MRA offers significantly greater diagnostic accuracy than conventional MRI for most shoulder pathologies, particularly SLAP and Bankart lesions. It should be considered the preferred imaging modality in CSP cases with suspected intra-articular injuries.
Saad et al. (Thu,) studied this question.