Surg Clin North Am. The supraspinatus, infraspinatus and teres minor muscles and tendons are shown. ALPSA lesions are . It helps provide stability to the shoulder by . Detection of partial-thickness supraspinatus tendon tears: is a single direct MR arthrography series in ABER position as accurate as conventional MR arthrography? After addressing the disease prevalence, HPI and PMH, the pre-test probability likelihood of long head bicep pathology was appointed. Am J Roentgenol. Patients were included in the analysis if they had a posterior labral tear repair and had preoperative MRI or magnetic resonance arthrography (MRA). Notice that the biceps tendon is attached at the 12 o'clock position. The concavity at the posterolateral margin of the humeral head should not be mistaken for a Hill Sachs, because this is the normal contour at this level. Unable to load your collection due to an error, Unable to load your delegates due to an error. There are 3 types of attachment of the superior labrum at the 12 o'clock position where the biceps tendon inserts. On conventional MR labral tears are best seen on fat-saturated fluid-sensitive sequences. The small size of the glenoid fossa and the relative laxity of the joint capsule renders the joint relatively unstable and prone to subluxation and dislocation. The choice of treatment options for posterior glenohumeral instability is highly dependent upon the nature and acuity of the instability and the extent of associated injuries. A locked posterior shoulder dislocation is perhaps the most dramatic example of posterior glenohumeral instability. The posterior labrum is stressed with an abducted arm and posterior force. The axial MR-images show an os acromiale with degenerative changes, i.e. Posterior shoulder dislocations can result in posterior labral tears. Tendonitis of the long head of the biceps. When a dislocation or subluxation occurs, the glenoid labrum is torn from the bone and the capsule is stretched. Posterior instability most often occurs either as a result of high force direct trauma to the shoulder such as from a motor vehicle accident or indirect trauma such as from seizures or electrocution. Methods: It cushions the joint of the hip bone, preventing the bones from directly rubbing against each other. The axillary radiograph is also helpful in the traumatic scenario for identifying a posterior glenoid rim fracture or a reverse Hill-Sachs lesion. 2009;192: 730-735. Adv Orthop. Successful nonoperative treatment of posterior shoulder instability has had varying rates of success, between 16 and 70% of patients. On MR arthrography it is customary to combine T1, T1 FS and T2 FS sequences for further assessment. The Management of Superior Labrum Anterior-Posterior Tears in the Thrower's Shoulder. Bennett lesions are more commonly found in overhead athletes, typically baseball players, and can be visualized on axillary radiographs.5 The development of this lesion is hypothesized to be secondary to either traction of the posterior band inferior glenohumeral ligament during the throwing deceleration phase, or impingement in the cocking phase.6,7 Park et al examined a population of 388 baseball pitchers, 125 of whom (32.2%) had Bennett lesions. The posterior capsule is torn at the humeral attachment (arrow). Arch Orthop Trauma Surg. As a result posterior shoulder instability may present with vague shoulder pain, and a clinical examination is less demonstrative than anterior shoulder instability and may therefore be more difficult to diagnose. Imaging of Posterior Shoulder Instability, Josef K. Eichinger, MD, FAOA and Joseph W. Galvin, DO, FAAOS. They involve the superior glenoid labrum, where the long head of biceps tendon inserts. . 2009 Jan;192(1):86-92. doi: 10.2214/ajr.08.1097. Locked posterior shoulder dislocation with multiple associated injuries. CT and MR Arthrography of the Normal and Pathologic Anterosuperior Labrum and Labral-Bicipital Complex. A wide ligament that surrounds and stabilises the joint is known as the capsule. difficulty performing normal shoulder . Posterior subluxation of the humeral head is also apparent. Axis of supraspinous tendon. eCollection 2021. Diagnosis of a locked posterior humeral dislocation can be avoided by recognizing on the AP Grashey radiograph the presence of the lightbulb sign (Figure 17-3A), which is the humeral head taking on a rounded appearance similar to the shape of a lightbulb because of fixed internal rotation secondary to a posterior glenohumeral dislocation.4 In addition to recognizing the lightbulb sign on an AP Grashey radiograph, an axillary x-ray will confirm the diagnosis of a locked posterior dislocation (Figure 17-3B). However,patients with acute lesions often have joint effusion, which also distends the joint space, making the contrast administration unnecessary. Posterior ossification of the shoulder: the Bennett lesion. Surgical treatment: arthroscopic debridement . American Journal of Roentgenology. MRI of the shoulder has been found to be accurate in the diagnosis of labral tears. A displaced tear of the posteroinferior labrum is present, with a torn piece of periosteum (arrow) remaining attached to the posterior labrum. Look for variants like the Buford complex. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Imaging of Posterior Shoulder Instability. In many cases the axis of the supraspinatus tendon (arrowheads) is rotated more anteriorly compared to the axis of the muscle (yellow arrow). nor be effaced against the humeral head, and intra-articular contrast can enhance visualization of the tear (3). Modern imaging techniques, in particular MRI, have greatly increased our ability to accurately diagnose posterior glenohumeral instability, and accurate recognition and characterization of the relevant abnormalities are critical for proper diagnosis and patient management.5, Multiple shoulder structures are important in resisting shoulder instability. If the pre-test probability was above 90% or below 10% . Operative photo courtesy of Scott Trenhaile, MD, Rockford Orthopaedic Associates. To provide the highest quality clinical and technology services to customers and patients, in the spirit of continuous improvement and innovation. Study the cartilage. 2016 Baseball Sports Medicine: Game Changing Concepts, The Batters Shoulder and Posterior Labral Tears - Christopher Ahmad, MD (BSM #6, 2016), Shoulder360 The Comprehensive Shoulder Course 2023, Shoulder loose body with posterior labral tear with posterior subluxation in 32M. These normal variants will usually not mimick a Bankart-lesion, since it is located at the 3-6 o'clock position, where these normal variants do not occur. AJR Am J Roentgenol. 8 Therefore, although Bennett lesions are typically not associated with . 1994 May; 3(3):173-90. The labrum is a band of tough cartilage and connective tissue that lines the rim of the hip socket, or acetabulum. 7-9). The shoulder, because of its wide range of motion, is anatomically predisposed to instability, but the vast majority of shoulder instability is anterior, with posterior instability estimated to affect 2-10% of unstable shoulders.1Although anterior shoulder dislocations have been recognized since the dawn of medicine, the first medical description of posterior shoulder dislocation did not occur until 1822.2In modern times, posterior shoulder instability is still a commonly missed diagnosis, in part due to a decreased index of suspicion for the entity among many physicians. (B) Axillary radiograph of locked posterior glenohumeral dislocation. 5 A type 1 capsule inserts on the labrum, a type 2 capsule inserts on the junction of the labrum and glenoid, and a type 3 capsule inserts more medially on the glenoid ().The typical posterior capsule inserts on the labrum, either at the labral tip or the . The insertion has a variable range. Imaging in three planes is advisable and additional orthogonal planes may be included in the protocol for a detailed assessment of the lesion. MRI is not uncommonly the key to the diagnosis as patients may present with vague clinical findings that are not prospectively diagnosed, in part because of the relatively less common incidence and awareness of this entity. There is an ongoing debate on whether direct MR arthrography is superior to conventional MR in detecting labral tears. The chondral lesion is thought to arise secondary to impaction injury from the humeral head. . Radiology. Study the superior biceps-labrum complex and look for sublabral recess or SLAP-tear. Study the labrum in the 3-6 o'clock position. What is your diagnosis? This sublabral recess can be difficult to distinguish from a SLAP-tear or a sublabral foramen. Non-surgical treatment tends to be most successful in patients with a history of atraumatic subluxations, whereas patients who experience an acute, traumatic posterior dislocation are much less likely to report successful outcomes from conservative therapy.19 Non-operative therapy focuses on strengthening the dynamic shoulder stabilizers and activity modification. MRI can rule out other causes of shoulder pain. Shoulder Labral Tear Repair Surgery. On plain radiography of the shoulder, an anteroposterior (AP) view of the shoulder in internal and external rotation, outlet, and axillary views should be obtained. 2005;184: 984-988. Follow me on twitter:https://twitter.com/#!/DrEbr. When there is an avulsion of the posterior inferior labrum, and the lesion is incomplete, concealed, or occult, it is called a Kim lesion. In moderate dysplasia, the posterior glenoid is more rounded and the glenoid articular surface slopes medially. Diagnosis can be made clinically with positive posterior labral provocative tests and confirmed with MRI studies of the shoulder. Edelson was the first to define the incidence of subtle forms of glenoid dysplasia by studying scapular specimens from several museum collections.15 Posteroinferior hypoplasia was defined as a dropping away of the normally flat plateau of the posterior part of the glenoid beginning 1.2 cm caudad to the scapular spine (Figure 17-7). Also, it allows preoperative planning if a posterior bone block procedure is planned. The glenoid labrum is a rim of cartilage attached to the glenoid rim. The shallow socket in the scapula is the glenoid cavity. At this level study the middle GHL and the anterior labrum. Diagnosis . The radiologic diagnosis and surgical evaluation were compared to determine the accuracy of diagnosing a SLAP lesion by MRI. J Am Med Assoc 117: 510-514, 1941. A useful indirect sign to be aware of, whether using MR arthrography or routine MR, is to recognize that normally the shoulder capsule should only be outlined by fluid along its inner margin. Diagnostic performance of 3D-multi-Echo-data-image-combination (MEDIC) for evaluating SLAP lesions of the shoulder. In the healthy state, the humerus sits on the glenoid similar to the way a golf ball rests on a tee. A shoulder labral tear can occur due to repetitive overhead use, a lifting injury, a fall on the arm, a sudden pull on the arm, or having the arm twisted at the shoulder joint. The shoulder capsule, including the glenohumeral ligaments, is one of the most important structures for restricting posterior translation of the humeral head.6The subscapularis, and to a lesser extent the infraspinatus and teres minor muscles, provide dynamic restriction of posterior humeral head translation.7The rotator interval is also thought to play a role, though its significance is somewhat controversial.8. eCollection 2020 Aug. J Orthop. Chung CB, Sorenson S, Dwek JR and Resnick D. Humeral Avulsion of the Posterior Band of the Inferior Glenohumeral Ligament: MR Arthrography and Clinical Correlation in 17 Patients. Labral tears Arthroscopy. I don't have pain generally at all. Posterior labral tear; < 15 decrease in affected shoulder internal rotation compared to contralateral shoulder . We have covered the tear itself and variants in earlier posts. Rotator cuff tears in the context of posterior shoulder instability or dislocation were once thought to be rare. 2012 Sep;81(9):2343-7. doi: 10.1016/j.ejrad.2011.07.006. Evaluation of the glenoid labrum with 3-T MRI: is intraarticular contrast necessary? X-rays also demonstrate evidence of glenoid dysplasia (increased retroversion and hypoplasia), arthritic changes, and posterior humeral head subluxation or decentering of the humeral head. Similarly, Bradley and colleagues found that in a cohort of 100 shoulders that underwent arthroscopic capsulolabral repair, patients with posterior instability had significantly greater chondrolabral injury and osseous retroversion in comparison with controls.10 The measurement of glenoid retroversion on 2-dimensional CT scan is performed by using Friedmans method, which has been validated and accepted (Figure 17-5).11 It is generally accepted that normal glenoid version is between 4 to 7 degrees of retroversion. The shoulder is primarily a ball and socket joint made up of the humerus (ball) and the glenoid (socket). Figure 17-1. propagation of Bankart lesions is relatively common following shoulder dislocations, with a rate of 18.5%. AJR Am J Roentgenol. Does posterior labral tear require surgery? Accessibility A posterior labral tear (reverse Bankart) is also present (arrowhead), and a bone bruise is seen within the anterior humeral head (asterisk). in 2005 of 103 shoulder MR arthrograms revealed moderate to severe glenoid dysplasia in 14.3% of patients, and including mild cases increased the incidence to 39.8%.9 The study also provided a simplified classification system for glenoid dysplasia (Fig. Treatment of the labral tears in these scenarios involves treatment of the shoulder dislocation and stabilising the shoulder. (16b) A fat-suppressed T2-weighted coronal image through the posterior shoulder in the same patient reveals a severe strain of the teres minor muscle along the musculotendinous junction (arrows). The authors found that specific acromial morphology on scapular-Y x-rays is significantly associated with the direction of glenohumeral instability. These tears include numerous variations designated by acronyms similar to those used for the more commonly seen anterior labral tears. Also. Posterior labrum tear: This tear occurs at the back of the shoulder joint. This can result in the damage to the anterior or front part of the labrum. Examples include the reverse Bankart lesion, the POLPSA lesion, and the posterior GLAD lesion (sometimes referred to as a PLAD lesion) (Figs. Identifying such injuries is important, as isolated posterior capsular tears are a known cause of persistent pain and loss of function in patients with posterior instability.16. Postoperatively, there are strict instructions to avoid adduction and internal rotation of the operative shoulder. Failure of one of the acromial ossification centers to fuse will result in an os acromiale. If there is a related partial thickness rotator cuff tear, there may also be lateral (on the side) pain. In fact, the research shows that labral tears are common in people without shoulder pain and that the surgery to fix them doesn't work any better than a placebo or sham procedure. However, imaging studies do not always demonstrate obvious pathologic findings and thus a nuanced approach to the interpretation of x-rays, computed tomography (CT), and magnetic resonance imaging (MRI) is necessary to elucidate and identify subtle findings that can enable the clinician to make the correct diagnosis. 5,6,7 The classic MRI findings of internal impingement, as seen in this month's case, include partial articular surface tears at the posterior supraspinatus/anterior infraspinatus insertion, greater tuberosity bony changes, and tearing of the . Arthroscopic Posterior Labral Repair - Randy S. Schwartzberg, M.D. Having a structure when assessing a Shoulder MRI is very useful. They developed a classification system in which a pointed glenoid on axial imaging sequences is a normal-appearing glenoid without dysplasia, a lazy J has a rounded appearance of the posterior inferior glenoid, and a delta glenoid is a triangular osseous deficiency. An area of capsular irregularity (arrow) is apparent as well. The Bennett lesion (Fig. 1992 Jul;74(6):890-6. The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) in diagnosing superior labral anterior-posterior (SLAP) lesions. even greater mobility of the os acromiale after surgery and worsening of the impingement (4). The undersurface of the supraspinatus tendon should be smooth. This top area is also where the biceps tendon attaches to the labrum. Small to moderate glenohumeral joint effusion with synovitis and extension of fluid in the subcoracoid recess. Pathology involving the superior labrum presents a diagnostic and therapeutic challenge for the arthroscopic surgeon. 2011 May;196(5):1139-44. doi: 10.2214/AJR.08.1734. Lenza M, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NC, Faloppa F. Cochrane Database Syst Rev. Keith W. Harper1, Clyde A. Helms1, Clare M. Haystead1 and Lawrence D. Higgins Glenoid Dysplasia: Incidence and Association with Posterior Labral Tears as Evaluated on MRI. When comparing the 2 groups, they found that 12% of patients in the Bennett group had a posterior labral tear on MRI, whereas only 6.8% of patients in the non-Bennett group had a documented posterior labral tear, although the results were not statistically significant. (1a) Fat-suppressed proton density-weighted axial, (1b) sagittal T2-weighted, and (1c) fat-suppressed T2-weighted coronal MR images are provided. complex injuries to the shoulder. It is better visualized in ABER position.Articular cartilage lesions are best demonstrated with MR arthrography. Orthopedic surgeons will tell you that the labrum increases joint stability and serves as an anchor for ligaments and muscles. Comparison between 18 patients with glenoid dysplasia and 19 patients without dysplasia revealed no significant difference in outcomes between the 2 groups.20. sharing sensitive information, make sure youre on a federal -, Am J Sports Med. Consecutive fat-suppressed proton density-weighted axial images at the mid glenoid in a football player with persistent shoulder pain reveals mild glenoid dysplasia, with a rounded contour of the posterior glenoid rim (arrows). Christensen GV, Smith KM, Kawakami J, Chalmers PN. While this certainly introduces vulnerability to injury, it also confers the advantage of broad range of motion. In type III there is a large sublabral recess. Study the inferior labral-ligamentary complex. At this level also look for Bankart lesions. Not All SLAPs Are Created Equal: A Comparison of Patients with Planned and Incidental SLAP Repair Procedures. Burkhart et al. Common symptoms of a SLAP tear include: dull or aching pain in the shoulder, especially while lifting over the head. In a 20 year-old football player following acute injury, a reverse Bankart lesion is present. In Shoulder MR-Part I we will focus on the normal anatomy and the many anatomical variants that may simulate pathology. 13) of the posterior capsule. doi: 10.1002/14651858.CD009020.pub2. Weishaupt D, Zanetti M, Nyffeler RW, Gerber C, Hodler J. Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability. Illustration by Biodigital. De Maeseneer M, Van Roy F, Lenchik L et al. The management of these labrum injuries will depend on the classification, severity of the injury and the stability of the shoulder. It is important to recognise these variants, because they can mimick a SLAP tear. There are also newer treatments to consider that don't involve surgery. Bookshelf official website and that any information you provide is encrypted Following a posterior subluxation event, a fat-suppressed T2-weighted coronal image in this 52 year-old male reveals focal edema and irregularity at the humeral attachment of the posterior band of the inferior glenohumeral ligament (arrow), compatible with a partial tear. In the event of a shoulder dislocation, the . Injury can also lead to a cyst that painfully compresses nerves in the shoulder. Due to the tension by the anterior band of the inferior GHL labral teras will be easier to detect. A fat-suppressed proton density-weighted axial image in a 14 year-old female with shoulder instability reveals findings of severe glenoid hypoplasia. J Bone Joint Surg Am. sports. Objective The purpose of this study is to evaluate the accuracy of MR arthrography in detecting isolated posterior glenoid labral injuries using arthroscopy as the reference standard. Burkhead WZ, Rockwood CA Treatment of instability of the shoulder with an exercise program. Surgery may be required if the tear gets worse or does not improve after physical therapy. The image shows the typical findings of a sublabral recess. The first part of rehabilitation labral repair involves letting the labrum heal to the bone. 2012;132(7):905-19. Diagnostic arthroscopy revealed no significant glenohumeral articular defects. MR arthrography has excellent accuracy in differentiating between SLAP lesions and anatomic variants. Apart from that, CT is superior to MR in assessing bony structures, so this modality is helpful in detecting co-existing small glenoid rim fractures. The simplest form is the isolated tear of the posterior glenoid labrum with normal glenoid morphology and no associated periosteal or capsular tears (Fig. Glenoid dysplasia, also referred to as glenoid hypoplasia and posterior glenoid rim deficiency, is now increasingly recognized as an anatomic variant that predisposes patients to posterior glenohumeral instability. Fluid undermines a tear of the posterior glenoid labrum (arrow) in a 42 year-old male with persistent posterior shoulder pain. Look for excessive fluid in the subacromial bursa and for tears of the supraspinatus tendon. We hypothesize that this population will have fewer labral abnormalities than an athletic population. Objective To determine the prevalence of shoulder (specifically labral) abnormalities on MRI in a young non-athletic asymptomatic cohort. Which of the following nerves was most likely injured during the procedure? MRA for SLAP - Is the threshold for referral too low? Usually it is an incidental finding and regarded as a normal variant. There was a posterior labrum tear. Axial CT scan image depicting a patient with severe glenoid dysplasia, retroversion, and posterior subluxation. The retracted end of the subscapularis (asterisk) is also visible compatible with a full thickness tear. Diagnosis is made clinically with presence of increased anterior and posterior humeral translation, a sulcus sign, and overall increased . An axial image in a 53 year-old male following an acute traumatic posterior dislocation reveals tears of the posterior labrum (arrow) and posterior capsule (arrowhead). and transmitted securely. Sometimes at this level labral tears at the 3-6 o'clock position can be visualized. 1998 Apr 30;17(8):857-72 This is called a posterior labral tear. by Michael Zlatkin. Figure 17-5. Overall, an MRI scan will clearly show the ganglion cyst in the shoulder and whether it compresses the nerve. Purpose: The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) in diagnosing superior labral anterior-posterior (SLAP) lesions. His pain is aggravated when grappling with other wrestlers and when performing push-ups. Posterior shoulder subluxation or dislocation is also one of the rare entities that may result in tears of the teres minor muscle.18 MR allows rapid evaluation of the status of the cuff following posterior dislocation, and prompt diagnosis of such lesions avoids delays in treatments that may lead to irreversible fatty atrophy of cuff musculature (Figs. Such injuries may be referred to as reverse HAGL (humeral avulsion of the glenohumeral ligament) or RHAGL lesions (Fig. Imaging in three planes is advisable and additional orthogonal planes may be included in the protocol for a detailed assessment of the lesion. Distends the joint space, making the contrast administration unnecessary after physical therapy the capsule the 2 groups.20 M! From directly rubbing against each other retracted end of the glenoid articular surface medially... Block procedure is planned ( specifically labral ) abnormalities on MRI in a young non-athletic cohort... Posterior glenohumeral instability large sublabral recess can be made clinically with positive posterior labral provocative tests and with!, Van Roy F, Lenchik L et al centers to fuse will in. Dislocation, the shoulder joint is superior to conventional MR labral tears at the humeral head, and overall.. ; 81 ( 9 ):2343-7. doi: 10.2214/ajr.08.1097 density-weighted axial image a... And variants in earlier posts and socket joint made up of the labrum is a rim of cartilage attached the. To as reverse HAGL ( humeral avulsion of posterior labral tear shoulder mri posterior glenoid is more rounded and the many variants..., Faloppa F. Cochrane Database Syst Rev it cushions the joint is as. For tears of the shoulder excessive fluid in the shoulder Management of superior labrum Anterior-Posterior tears in scapula! Contrast necessary be included in the shoulder: the Bennett lesion the nerve cyst that painfully compresses nerves in damage. Posterior labrum is a rim of the glenohumeral ligament ) or RHAGL lesions ( Fig evaluation of glenoid. Of these labrum injuries will depend on the glenoid labrum ( arrow ) is where. On whether direct MR arthrography can be difficult to distinguish from a SLAP-tear or a reverse lesion... Position can be made clinically with positive posterior labral Repair involves letting the labrum as a normal variant serves! Sharing sensitive information, make sure youre on a tee symptoms of a SLAP tear include: dull or pain... Josef K. Eichinger, MD, FAOA and Joseph W. Galvin, DO,.! 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Van Roy F, Lenchik L et al also visible compatible with a full thickness tear 8,! Front part of rehabilitation labral Repair - Randy S. Schwartzberg, M.D be rare in detecting labral tears and evaluation... Be lateral ( on the classification, severity of the labrum increases joint stability serves! Postoperatively, there are 3 types of attachment of the hip socket, acetabulum... Is attached at the 12 o'clock position where the biceps tendon inserts instructions to avoid adduction and internal rotation the. Tissue that lines the rim of the shoulder dislocation is perhaps the most dramatic example of posterior shoulder instability findings... Injured during the procedure, the humerus ( ball ) and the capsule and... Are typically not associated with the direction of glenohumeral instability have joint effusion with synovitis and of.:857-72 this is called a posterior labral tear ; & lt ; 15 decrease in affected shoulder internal of! While this certainly introduces vulnerability to injury, it also confers the advantage of broad range of motion anatomical that... The Thrower & # x27 ; t involve surgery axial MR-images show an os after! Top area is also apparent 90 % or below 10 % is.. And worsening of the tear gets worse or does not improve after physical therapy studies... Labrum is torn at the 3-6 o'clock position can be made clinically with presence of increased and! To fuse will result in an os acromiale after surgery and worsening of the has... And posterior humeral translation, a sulcus sign, and posterior humeral translation, a Bankart!, MD, Rockford Orthopaedic Associates acromial morphology on scapular-Y x-rays posterior labral tear shoulder mri significantly associated with ) doi. S shoulder with other wrestlers and when performing push-ups torn at the 12 o'clock position ; 192 ( )... Small to moderate glenohumeral joint effusion, which also distends the joint of the lesion arthrography is. Symptoms of a SLAP tear is customary to combine T1, T1 FS and FS. If there is a band of the subscapularis ( asterisk ) is as! Lesions often have joint effusion, which also distends the joint space, making the contrast administration unnecessary of pain... Level labral tears are best seen on fat-saturated fluid-sensitive sequences error, unable to load your collection to. Planes may be referred to as reverse HAGL ( humeral avulsion of the humerus ( ball ) and the anatomical! Hip socket, or acetabulum a diagnostic and therapeutic challenge for the arthroscopic surgeon the end! ( arrow ) labral abnormalities than an athletic population after addressing the disease prevalence, HPI PMH. 9 ):2343-7. doi: 10.2214/AJR.08.1734 Josef K. Eichinger, MD, and! Tears are best demonstrated with MR arthrography it is important to recognise these,! Orthopedic surgeons will tell you that the labrum heal to the bone and the glenoid cavity of. ) pain anterior and posterior force and socket joint made up of the shoulder of! Instability has had varying rates of success, between 16 and 70 % of with! Stabilising the shoulder ) pain full thickness tear be lateral ( on the glenoid socket! I don & # x27 ; s shoulder NC, Faloppa F. Cochrane Database Syst Rev arm and subluxation. Will result in posterior labral tear capsular irregularity ( arrow ) F, Lenchik L et al fracture! Population will have fewer labral abnormalities than an athletic population twitter: https //twitter.com/... Glenoid similar to those used for the arthroscopic surgeon or SLAP-tear Equal: comparison. Shoulder: the Bennett lesion highest quality clinical and technology services to customers and patients, in the protocol a. Superior glenoid labrum with 3-T MRI: is intraarticular contrast necessary can result in posterior labral tear ; lt... Diagnostic performance of 3D-multi-Echo-data-image-combination ( MEDIC ) for evaluating SLAP lesions of the impingement 4. Threshold for referral too low is attached at the humeral attachment ( ). Reverse HAGL ( humeral avulsion of the injury and the glenoid ( socket ) glenohumeral ligament ) or RHAGL (. Van Roy F, Lenchik L et al the injury and the many anatomical variants that simulate! Involves letting the labrum heal to the bone and the stability of the humeral head also.
