Louis Herman Wetzel MD, Presenter: Nothing to Disclose

Rona Kaiser Gazaway MD, Abstract Co-Author: Nothing to Disclose

Kristen Lem Mygdal MD, Abstract Co-Author: Nothing to Disclose

Vincent Key MD, Abstract Co-Author: Nothing to Disclose

Judson Bertsch MD, Abstract Co-Author: Nothing to Disclose

To determine the frequency of subchondral marrow edema of the glenoid associated with labral tears and determine whether it is a useful secondary sign of labral tear at shoulder MRI.

We retrospectively reviewed MRI shoulder studies on 18 patients with arthroscopically proven labral tears for the presence of subchondral marrow edema. Location and degree of marrow edema( mild, moderate, marked ) were determined by concensus of the authors. The labrum was evaluated for tear as: no tear evident, possible, probable, or definite. Effusion was noted as absent, mild, moderate or marked. We also reviewed 20 MRI studies on patients without labral tear on arthroscopy or glenoid trauma for subchondral marrow edema to serve as controls.

Nine of 18 patients with labral tears had subchondral marrow edema. Eight were mild in degree and one moderate. Six of the tears were clearly evident by direct inspection of the labrum while three were difficult to detect.

Labral tears are difficult to evaluate on MRI without contrast. Subtle subchondral marrow edema may accompany labral tears in about half of cases and may therefore be useful as a secondary supportive sign of labral tear. In a patient with clinical sucspicion of labral tear, the finding of marrow edema with equivocal appearance of the labrum may be an indication for further evaluation with MR Arthrogram or Arthroscopy.

Wetzel, L, Gazaway, R, Mygdal, K, Key, V, Bertsch, J, Subchondral Marrow Edema of the Glenoid: An Indirect Sign of Labral Tear at Shoulder MRI.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4406027.html