Thomas Henry Magee MD, Presenter: Nothing to Disclose

Shoulder surgeons commonly intervene on unstable labral tears (those tears that displace with patient movement). Surgeons can detect unstable tears at surgery. It is difficult to be certain a tear is unstable on a static MR image. We report the benefit of pre and post arthrogram MR imaging in detection of unstable labral tears.

       One hundred fifty consecutive conventional shoulder MR and MR arthrography exams performed on the same patients were reviewed retrospectively by consensus reading of two musculoskeletal radiologists. Both conventional MR and MR arthrogram exams were performed on each patient on the same day. Labral tears were assessed. It was also determined if there was any difference in position of the labral tear comparing pre and post arthrographic images.. All patients went on to arthroscopy.

      Of these one hundred fifty patients, ninety -four had SLAP (superior labral anterior to posterior) tears , fifty three had posterior labral tears and forty two had anterior labral tears on MR exam.       All one hundred fifty patients went on to arthroscopy. All lesions described on MR were described on arthroscopy. Twenty three SLAP tears, sixteen posterior labral tears and seventeen anterior labral tears demonstrated a change in the position of the labral tear on pre versus post arthrographic images. All of these labral tears were considered unstable by the surgeon and all of these. patients had surgical tacking performed.        There were five SLAP tears, three anterior labral tears and four posterior labral tears seen on arthroscopy not seen on MR or MR arthrography examination.    

      In this study. pre and post arthrogram MR imaging of the shoulder was useful in demonstrating unstable labral tears in twenty three patients with SLAP tears, sixteen patients with posterior labral tears and seventeen patients with anterior labral tears. This information was useful in surgical planning.

Pre and post arthrogram MR imaging of the shoulder is useful in demonstrating unstable labral tears. This information is useful in pre surgical planning.

Magee, T, Usefulness of Pre and Post MR Arthrogram Imaging of the Shoulder in Detection of Unstable Labral Tears.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13010751.html