Thomas Henry Magee MD, Presenter: Nothing to Disclose

We report the prevalence of surgical intervention on shoulder labral lesions detected at MR examination.

A retrospective review was made of 100 consecutive patients who had shoulder labral tears described on MR examination and who went to subsequent surgery. Surgical reports were correlated with MR examinations. It was specifically determined whether surgical intervention (i.e. surgical tacking or debridement) was performed on the lesions described on MR exam.

Of these one hundred patients, seventy-two had SLAP (superior labral anterior to posterior) tears described on MR exam, Thirty eight patient had posterior labral tears described on MR exam and twenty eight had anterior labral tears described on MR exam. All one hundred patients went on to arthroscopy. All seventy- two SLAP tears, thirty- eight posterior labral tears and twenty- eight anterior labral tears described on MR were described on arthroscopy. Of the seventy- two SLAP tears, sixty- four were described as fraying on arthroscopy. Of these sixty- four cases, fourteen were debrided. In fifty cases no surgical intervention was performed. The remaining eight SLAP tears were described as SLAP tears on arthroscopy and surgical tacking was performed. Of the thirty- eight posterior labral tears, thirty- six were described as fraying on arthroscopy. Of these thirty-six patients, seven were debrided. In twenty-nine cases there was no surgical intervention. Two of the thirty- eight had surgical tacking performed arthroscopically. Of the twenty- eight anterior labral tears described on MR exam twenty- six had surgical tacking performed. Two of the twenty- eight had their anterior labrum debrided arthroscopically.  

In this series, a high percentage of SLAP tears and posterior labral tears described on MR examination did not have surgical tacking or debridement performed. Most anterior labral tears had surgical tacking performed. Based on the above results our surgeons request we describe superior and posterior labral lesions as fraying and /or tearing unless we can clearly see a displaced tear. Most anterior labral lesions are treated surgically.

Most  SLAP and posterior labral tears on MR examination do not have surgical intervention performed.  They are better described as fraying/tearing on MR exam unless clearly demonstrated as displaced.

Magee, T, How Often Do Surgeons Intervene on Shoulder Labral Lesions Detected at MR Exam?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9001210.html