Efficacy of Diagnostic Magnetic Resonance Imaging for Articular Cartilage Lesions of the Glenohumeral Joint in Patients with Instability

Overview

Journal Skeletal Radiol

Specialties Orthopedics
Radiology

Date 2010 Apr 23

PMID 20411385

Citations 15

Authors

Meredith L Hayes

Mark S Collins

Joseph A Morgan

Doris E Wenger

Diane L Dahm

Affiliations

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Abstract

Objective: The purpose of this study was primarily to assess the diagnostic performance of magnetic resonance imaging (MRI) in detecting articular cartilage injuries in patients with glenohumeral instability. A secondary purpose was to assess the diagnostic performance of MRI for detection of Hill-Sachs and Bankart lesions.

Materials And Methods: A cohort of 87 consecutive patients who underwent diagnostic MRI and shoulder arthroscopy for instability from 1997 to 2006 were identified. Fifty-five patients (63.2%) underwent MRI with intra-articular contrast medium and 32 patients (36.8%) underwent MRI without contrast medium. MR images were reviewed by two radiologists and interpreted by consensus for the presence of articular cartilage lesions (including Hill-Sachs and Bankart lesions), which were then confirmed by reviewing the operative report and images recorded at arthroscopy.

Results: Mean patient age was 27.0 ± 10.2 years with a mean clinical and radiographic follow-up of 29 (range 3-72) months. Cartilage injuries were detected arthroscopically in 55 patients (63%). Bankart and Hill-Sachs lesions were identified arthroscopically in 66 patients (75.9%) and 55 patients (63.2%) respectively. The overall sensitivity and specificity for detection of glenohumeral articular cartilage lesions by MRI were 87.2% and 80.6% respectively. The sensitivity and specificity of MRI in detecting Bankart lesions was 98.4% (95% CI 91.9, 99.7) and 95.2% (95% CI 77.3, 99.2) respectively. The sensitivity and specificity of MRI in detecting Hill-Sachs lesions was 96.3% (95% CI 87.6, 98.9%) and 90.6% (95% CI 75.7, 96.9) respectively. No statistically significant difference was found between MRI examinations with and without intra-articular gadolinium (p = 0.89).

Conclusion: Magnetic resonance imaging demonstrates high sensitivity and specificity for the diagnosis of articular cartilage injuries in patients with glenohumeral instability. MRI with or without intra-articular contrast medium in this study were equally reliable as a non-invasive method for assessment of articular cartilage damage of the glenohumeral joint prior to diagnostic arthroscopy.

Citing Articles

Comparison of conventional MR arthrography and 3D volumetric MR arthrography in detection of cartilage defects accompanying glenoid labrum pathologies.

Gokce A, Guclu D, Unlu E, Kazoglu I, Arican M, Ogul H Skeletal Radiol. 2023; 53(6):1081-1090.

PMID: 38051423 DOI: 10.1007/s00256-023-04536-9.

Variability in quantifying the Hill-Sachs lesion: A scoping review.

Khan S, Shanmugaraj A, Faisal H, Prada C, Munir S, Leroux T Shoulder Elbow. 2023; 15(5):465-483.

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Interobserver agreement for detecting Hill-Sachs lesions on magnetic resonance imaging.

Alkaduhimi H, Saarig A, Amajjar I, Van der Linde J, van Wier M, Willigenburg N Clin Shoulder Elb. 2021; 24(2):98-105.

PMID: 34078018 PMC: 8181846. DOI: 10.5397/cise.2021.00115.

New quantitative method to measure the Hill-Sachs lesion: validation of Hardy's radiographic method for MRI/AMRI.

Franca F, Godinho A, Ribeiro E, Ranzzi A, Bittencourt B, Barreto B Rev Bras Ortop. 2018; 53(5):589-594.

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Imaging of the Unstable Shoulder.

Baudi P, Rebuzzi M, Matino G, Catani F Open Orthop J. 2017; 11:882-896.

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