Sherif Abdelfattah MD, PhD, Presenter: Nothing to Disclose

Hassan Kassem MD, Abstract Co-Author: Nothing to Disclose

Ayman Hamdy Gaballah MD, FRCR, Abstract Co-Author: Nothing to Disclose

To compare direct MR arthrography  and CT arthrography for the preoperative planning of shoulder anterior instability.

43 Patients with clinical history of anterior GHI or recurrent shoulder pain were included in this study. -Those patients had no clinical findings of rotator cuff abnormality . They experienced multiple anterior dislocation of the shoulder. -No patient showed evidence of multiderictional instability or generalised ligamentous laxity. 4  patients complaining of anterior shoulder instability after anchor repair. All the patients underwent direct CT and MR arthrography. The results of CTA and MTA were compared with results obtained from arthroscopy or arthrotomy in each patient to detect the sensitivity and specificity of each modality

The sensitivity and specificity of CTA for bankart lesion are 89.4% and 95.8% respectively and of MRA 94.7% and 95.8%, for ALPSA the sensitivity and specificity of CTA are 100% and 100% respectively and for MRA 96.4% and 97.2%. ,for Perths lesion the sensitivity and specificity of CTA are 33.3% and 97.5% respectively and for MRA 66.6% and 97.5%, for GLAD the sensitivity and specificity of CTA are 100% and 100% respectively and for MRA 100% and 97.2%, for absent labrum the sensitivity and specificity of CTA are 100% and 97.2% respectively and for MRA 83.3% and 97.2% for bony fracture the sensitivity and specificity of CTA are 100% and 100% respectively and for MRA 60% and 97.3%.

CTA and MRA were equivalent in demonstrating labro-ligamentous and cartilaginous lesions associated with shoulder instability. CTA was superior in detecting post operative instability and glenoid rim osseous lesions that are known to be a decisional element in the surgical strategy. Hence, CTA may be considered a method of choice in the preoperative evaluation of shoulder anterior instability.

CTA and MRA were equivalent in demonstrating labro-ligamentous and cartilaginous lesions associated with shoulder instability. CTA was superior in detecting post operative instability and glenoid rim osseous lesions that are known to be a decisional element in the surgical strategy. Hence, CTA may be considered a method of choice in the preoperative evaluation of shoulder anterior instability.

Abdelfattah, S, Kassem, H, Gaballah, A, Comparative Study of Direct MR Arthrography and CT Arthrography with Arthroscopic Correlation in Preoperative Evaluation of Anterior Shoulder Instability.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12022731.html