Chronic labral tears: value of magnetic resonance arthrography in evaluating the glenoid labrum and labral-bicipital complex.

Authors: Applegate GR, Hewitt M, Snyder SJ, Watson E, Kwak S, Resnick D.

References: Arthroscopy. 2004 Nov;20(9):959-63.

Abstract
PURPOSE: In the magnetic resonance (MR) evaluation of the glenoid labrum, all studies to our knowledge have included mixed populations of patients, those with acute shoulder injuries as well as patients with chronic shoulder disorders. The focus of this investigation was to assess the effectiveness of MR arthrography in patients with chronic labral tears, excluding those with acute injuries. TYPE OF STUDY: Prospective case series. METHODS: Conventional MR images and MR arthrograms were obtained in 36 patients from April 1994 to April 1997. A single experienced musculoskeletal radiologist read all MR images. Each patient subsequently underwent shoulder arthroscopy performed by a single highly experienced shoulder arthroscopist. Detailed arthroscopic reports were then reviewed and compared with the MR findings documented before surgery, with arthroscopic findings being the standard of reference for comparison. Inclusion criteria required greater than 6 months of shoulder symptoms before imaging, thus eliminating acute injuries. RESULTS: SLAP lesions were diagnosed at the time of surgery in 11 of 36 patients (31%). The sensitivity was 100% (11 of 11 patients) and the specificity was 88% (22 of 25 patients). Accuracy for SLAP lesions was 92% (33 of 36 patients). Anterior labral tears were diagnosed surgically in 12 of 36 patients (33%). The sensitivity was 86% (12 of 14 patients) and specificity was 86% (19 of 22 patients). Accuracy for labral tears was 86% (31 of 36 patients). CONCLUSIONS: MR arthrography is an accurate technique for assessing the glenoid labrum in patients with chronic labral tears. LEVEL OF EVIDENCE: Level I.