Key result
A dynamic ABER GRE sequence added to MR shoulder arthrograms accurately detected instability (AUC=0.88) and correlated with subjective instability (P=0.026), but not with apprehension testing.
Why the study?
Does a dynamic ABER GRE sequence added to MR shoulder arthrograms correlate with subjective instability and clinical apprehension testing in symptomatic patients?
Cohort (n=15)
Does a dynamic ABER GRE sequence added to MR shoulder arthrograms correlate with subjective instability and clinical apprehension testing in symptomatic patients?
A dynamic ABER sequence added to MR shoulder arthrograms demonstrates humeral head translation that correlates with subjective instability but not with clinical apprehension testing.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for dynamic ABER sequences in shoulder MR arthrography; prospective validation required before clinical adoption.
Background Rapid real-time magnetic resonance (MR) sequences enable dynamic articular kinematic assessment. The abduction-external rotation (ABER) position has long been used to characterize glenohumeral pathology. Purpose To evaluate a dynamic gradient recall echo (GRE) sequence for ABER-positioned glenohumeral joint kinematic assessment correlating with subjective instability and clinical apprehension testing. Material and Methods Symptomatic patients were scanned using a routine MR arthrogram protocol supplemented by an additional “dynamic ABER” GRE technique acquired with the arm abducted and then internally-externally rotated in real time. Dynamic motion of the humeral head between the extremes of motion in the abducted and externally rotated positions was evaluated. The cohort was followed for 3 years. Results A total of 15 dynamic ABER studies in 15 different patients were evaluated by three readers (right: n=9; left: n=6), with a mean age of 30 years (range=19–45 years). Good accuracy of the humeral head excursion between the abducted and externally-internally rotated positions (AUC=0.88) was observed as a test for positively detecting instability. An association was detected between clinical instability and mean humeral head excursion as measured by all three readers ( P = 0.026), although no association between positive apprehension testing and mean humeral head excursion was detected. There was a trend towards surgery-naïve patients with higher mean humeral head excursion subsequently undergoing surgical management ( P =0.088), although this did not reach statistical significance. Conclusion Correlation between subjective instability and humeral head translation demonstrated on a dynamic ABER sequence added to MR shoulder arthrograms was observed but without association with clinical apprehension testing.
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Zech et al. (2025) conducted a cohort in glenohumeral pathology and instability (n=15). Dynamic ABER GRE sequence was evaluated on accuracy of humeral head excursion for detecting instability (AUC 0.88, p=0.026). A dynamic ABER GRE sequence added to MR shoulder arthrograms accurately detected instability (AUC=0.88) and correlated with subjective instability (P=0.026), but not with apprehension testing.
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