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Erschienen in: European Radiology 6/2014

01.06.2014 | Musculoskeletal

MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder

verfasst von: Christoph Schaeffeler, Simone Waldt, Jan S. Bauer, Chlodwig Kirchhoff, Bernhard Haller, Michael Schröder, Ernst J. Rummeny, Andreas B. Imhoff, Klaus Woertler

Erschienen in: European Radiology | Ausgabe 6/2014

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Abstract

Objective

To evaluate diagnostic signs and measurements in the assessment of capsular redundancy in atraumatic multidirectional instability (MDI) of the shoulder on MR arthrography (MR-A) including abduction/external rotation (ABER) images.

Methods

Twenty-one MR-A including ABER position of 20 patients with clinically diagnosed MDI and 17 patients without instability were assessed by three radiologists. On ABER images, presence of a layer of contrast between the humeral head (HH) and the anteroinferior glenohumeral ligament (AIGHL) (crescent sign) and a triangular-shaped space between the HH, AIGHL and glenoid (triangle sign) were evaluated; centring of the HH was measured. Anterosuperior herniation of the rotator interval (RI) capsule and glenoid version were determined on standard imaging planes.

Results

The crescent sign had a sensitivity of 57 %/62 %/48 % (observers 1/2/3) and specificity of 100 %/100 %/94 % in the diagnosis of MDI. The triangle sign had a sensitivity of 48 %/57 %/48 % and specificity of 94 %/94 %/100 %. The combination of both signs had a sensitivity of 86 %/90 %/81 % and specificity of 94 %/94 %/94 %. A positive triangle sign was significantly associated with decentring of the HH. Measurements of RI herniation, RI width and glenoid were not significantly different between both groups.

Conclusions

Combined assessment of redundancy signs on ABER position MR-A allows for accurate differentiation between patients with atraumatic MDI and patients with clinically stable shoulders; measurements on standard imaging planes appear inappropriate.

Key Points

MR arthrography has the possibility to accurately identify patients with atraumatic MDI.
Imaging of the shoulder in abduction and external rotation provides additive information.
Capsular enlargement of the shoulder can be diagnosed on MR arthrography.
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Metadaten
Titel
MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder
verfasst von
Christoph Schaeffeler
Simone Waldt
Jan S. Bauer
Chlodwig Kirchhoff
Bernhard Haller
Michael Schröder
Ernst J. Rummeny
Andreas B. Imhoff
Klaus Woertler
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 6/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3133-x

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