Taruna Ralhan MD, Presenter: Nothing to Disclose

Dane Carlisle Van Tassel BS, Abstract Co-Author: Nothing to Disclose

Randy Ray Richardson MD, Abstract Co-Author: Nothing to Disclose

There is limited data on the MRI features of posterior shoulder dislocation in pediatric patients with Erb’s palsy. The purpose of this study is to describe the MRI appearance of the different types of anatomy seen on MRI of the shoulder in patients with chronic Erb’s palsy.

A retrospective review of 21 MRIs of the shoulder in 21 pediatric patients with clinical diagnosis or suspicion of Erb’s palsy, at St. Joseph’s Hospital, over the last 10 years.

9 of the 21 studies showed a normal MRI of the shoulder. 7 studies (33%) showed posterior subluxation of the humeral head with distortion of the posterior bony glenoid rim and marked thickening of the posterior cartilaginous labrum. 4 of the 21 exams (19%) had frank dislocation of the humeral head and distortion of the posterior bony glenoid. In all of the dislocated patients the posterior labrum was not visible. 1 of the 21 patients had a thickened posterior labrum with no significant distortion or contouring of the posterior bony glenoid rim. Surgical confirmation of the anatomy was obtained in 4/15 patients with surgical disease. The others have not had surgery.  

Perinatal brachial plexus birth injuries have spontaneous recovery in up to 80% of injuries; however, approximately 25% continue to have sequelae secondary to the injury. MRI is an effective tool in determining the anatomy of the posterior glenoid in patients with Erb’s palsy.

MRI is an effective tool in determining the anatomy of the posterior glenoid in patients with Erb’s palsy and provides important information for surgical repair for stabilization.

Ralhan, T, Van Tassel, D, Richardson, R, MRI of the Shoulder in Chronic Erb's Palsy Patients: Anatomic Variations of the Posterior Glenoid.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9014505.html