Why the study?
Does saline magnetic resonance arthrography accurately detect glenohumeral instability compared to examination under anesthesia?
Does saline magnetic resonance arthrography accurately detect glenohumeral instability compared to examination under anesthesia?
Saline MR arthrography is highly sensitive and specific for detecting labral tears and correlates well with EUA-documented instability for Bankart and Hill-Sachs lesions.
Supports diagnostic utility of saline MR arthrography in instability; leaves open prospective validation against EUA.
Sixty-five patients underwent magnetic resonance (MR) shoulder arthrography. Forty-eight of these patients underwent examination under anesthesia (EUA). MR images were retrospectively evaluated for signs felt to be imaging indicators of shoulder instability, including evaluation of various capsular measurements and the presence of glenoid labral tears, as well as Hill-Sachs fractures. Statistical analysis of the results showed that no correlation between capsular indicators with EUA-documented instability was found. However, there was a statistically significant correlation between the presence of a Bankart cartilaginous deformity (p = 0.000) and Hill-Sachs fractures (p = 0.022) with EUA-documented instability. Sensitivity to labral tears was 89% and specificity was 98%, whereas Hill-Sachs fracture detection was 69% and 87%, respectively. We believe that MR saline arthrography is of benefit in the evaluation of the anterior labrum when unenhanced MR imaging is inconclusive, and we speculate on the role of MR arthrography as a primary investigative tool.
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Tirman et al. (1993) studied this question.
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