Maria Teresa Guedez MD, Abstract Co-Author: Nothing to Disclose

Eva Llopis MD, Presenter: Nothing to Disclose

Ernesto Hernandez, Abstract Co-Author: Nothing to Disclose

Antonio Cruz MD, Abstract Co-Author: Nothing to Disclose

Victoria Higueras MD, Abstract Co-Author: Nothing to Disclose

Luis Cerezal MD, Abstract Co-Author: Nothing to Disclose

Improving diagnosis of SLAP and biceps-labral complex lesions, by adding forced external rotation to MR arthrography (MRA) in internal or neutral position

We prospectively evaluated 54 patients with clinically suspected SLAP lesions. Patients complained of "dead arm syndrome", sudden onset of pain and glenohumeral internal rotation deficit. All patients had direct MRA at 1.5T. Internal rotation sequences were obtained in coronal, axial and sagittal planes subsequently coronal and axial T1-weighted fat suppressed sequences with the arm in maximal external rotation were obtained. SLAP lesions were classified using the extended Snyder classification and clockwise arthroscopic classification. MRA was correlated with arthroscopy

Twelve of 54 patients did not have SLAP lesions but anterior capsular detachment (2 patients), rotator interval injury (4), partial thickness rotator cuff tear (6). Surgically confirmed SLAP lesions were found in 42 patients, type I (3), type II (13), type III (7), type IV (3), type V (9), type VII (3), type VIII (I) and type X (4). In all patients external rotation improved the visualization of biceps superior labral junction, facilitating differentiation from normal variants, and increasing confidence of radiologic diagnosis. In 19%, (9 patients) external rotation allowed diagnosis of SLAP lesions non seen on conventional internal rotation. SLAP lesions were better detected with external rotation, size of lesions increased by mean of 0.61mm

External rotation position on shoulder MRI improves diagnosis of SLAP lesions, depiction, extension and diagnosis of associated injuries. Combined internal and external rotation shoulder MR-arthrography is recommended when SLAP lesions are clinically suspected

Biceps labral complex and SLAP injuries are more frequent than were thought, is a radiological challenge. Adding external rotation is a simple method to increase diagnostic accuracy for SLAP lesions.

Guedez, M, Llopis, E, Hernandez, E, Cruz, A, Higueras, V, Cerezal, L, External Rotation Improves Diagnostic Yield of MR Arthrography When Added to Conventional Internal Positioning in Patients Clinically Suspected of Having SLAP Lesions.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6010842.html