Abstract:
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Purpose: Shoulder injuries are common in high performance athletes who perform overhead activities such as throwing. MR imaging of the shoulder is commonly performed in such athletes. Some authors have suggested MR arthrography should be performed on all MR shoulder patients to increase accuracy of diagnosis. In most practices this is impractical due to patient reluctance to have an invasive test and due to scheduling constraints. We report our experience in diagnostic accuracy in conventional MRI as opposed to MR arthrography of the shoulder in high performance athletes (professional baseball players).
Methods and Materials: 20 consecutive conventional shoulder MR and MR arthrography exams performed on professional baseball players were read prospectively and reviewed retrospectively. Conventional MR exams included T2 fat saturated coronal and sagittal, T1 coronal and axial proton density fat saturated images. Patients then had arthrography performed with a gadolinium/saline mixture and subsequently axial, coronal and sagittal fat saturated T1 weighted images were performed. Scans were assessed for full or partial thickness supraspinatus tendon tears, SLAP tears and anterior or posterior labral tears.
Results: In these 20 consecutive patients, eight partial thickness undersurface supraspinatus tendon tears were seen on MR arthrography but not on conventional MR imaging. Three SLAP tears and two anterior labral tears were seen on MR arthrography that were not seen on conventional MR imaging. Of these thirteen patients with additional findings on MR arthrography, ten had arthroscopic correlation. In all ten cases arthroscopic findings confirmed findings on MR arthrography.
Conclusion: There is a high incidence of positive findings on shoulder MR and MR arthrography in high performance athletes with shoulder pain. MR arthrography is considerably more sensitive for detection of partial thickness supraspinatus tears and labral tears than conventional MR imaging. Based on the above findings, we perform shoulder MR arthrography on all high performance athletes in our practice.
Magee MD, T,
Utility of Shoulder MR Arthrography in High Performance Athletes. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3100973.html
