Hotaek Song MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To introduce evaluate the usefulness of ADIR position MR arthrography in the evaluation of anterior inferior labral lesions on the emphasis of discriminating Bankart lesion, ALPSA, Perthes lesion Adduction internal rotation of the shoulder pulls the humeral head to the anterior inferior direction. So anterior capsule is released and distended. Methods and Materials: The study group comprised 19 patients with an episode of recurrent shoulder dislocation who were referred for MR arthrography of the shoulder and then underwent arthroscopy. The shoulder was imaged in three different positions: neutral axial, abduction internal rotation (ABER), and adduction internal rotation (ADIR) axial positions. Two musculoskeletal radiologists who were blinded to arthroscopic results retrospectively evaluated each MR image of the three different positions in a separate session for the detection of the anterior inferior labral lesions. Translation of the humeral head and rotation angle are measured in each patient. Results: Total number of lesions on arthroscopy were; Bankart lesion 11, ALPSA 14, Perthes lesion 4 and combined lesion of Bankart lesion and ALPSA 6, ALPSA and Perthes lesion 4. Mean rotation angle from neutral to ADIR position was 45.59 degree. Anterior translation of humeral head was not significant (range from -1.16 to 4.85mm, mean 0.7mm) in ADIR position. Sensitivity of anterior inferior labral lesion in each position (neutral, ABER, ADIR) were 90.9%, 55.6%, 72.7% for Bankart lesion, 64.3%, 50%, 84.6% for ALPSA, and 25% all for Perthes lesion. Overall sensitivity of MR arthrography regardless of the three different positions was 81.8%, 71.4%, and 25% for Bankart lesion, ALPSA and Perthes lesion respectively. For the ALPSA lesion, interpretation of ADIR position alone, or in combination with neutral or ABER positions revealed higher sensitivity (p<0.05) than other combined results. For Bankart lesion neutral position (90.9%) showed higher sensitivity than the other results, but the difference was not statistically significant (p>0.05). Conclusion: MR arthrography with ADIR position would help in discriminating anterior inferior labral lesions of the patients with recurrent shoulder dislocation if it is used with neutral and ABER position MR study.       Questions about this event email: hotsong@yumc.yonsei.ac.kr

Song MD, H, Anterior Inferior Labral Lesions of Recurrent Shoulder Dislocation Evaluated with MR Arthrography with Adduction Internal Rotation (ADIR) Position.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3100855.html