Role of MR arthrography In Assessment of Glenohumeral Instability

Background: The glenohumeral joint has a unique structure which allows for the widest range of motion among all joints in the human body; however this unfortunately makes the joint inherently unstable. Various imaging techniques are available for assessment of shoulder joint abnormalities. Magnetic...

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Main Authors: Hamdan Abdelhameed Aly, Mohammad Hassan Alkousy, Khaled Fawzy Zaky, Mohammad Tharwat Mahmoud Solyman
Format: Article
Language:English
Published: South Valley University, Faculty of Medicine 2021-08-01
Series:SVU - International Journal of Medical Sciences
Subjects:
Online Access:https://svuijm.journals.ekb.eg/article_197400.html
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author Hamdan Abdelhameed Aly
Mohammad Hassan Alkousy
Khaled Fawzy Zaky
Mohammad Tharwat Mahmoud Solyman
author_facet Hamdan Abdelhameed Aly
Mohammad Hassan Alkousy
Khaled Fawzy Zaky
Mohammad Tharwat Mahmoud Solyman
author_sort Hamdan Abdelhameed Aly
collection DOAJ
description Background: The glenohumeral joint has a unique structure which allows for the widest range of motion among all joints in the human body; however this unfortunately makes the joint inherently unstable. Various imaging techniques are available for assessment of shoulder joint abnormalities. Magnetic resonance arthrography is considered the best modality for the assessment of disorders related to shoulder instability. The injection of para magnetic contrast solution into the joint cavity induced distension of the capsule allowing separation of the intra articular structures and beret visualization of shoulder disorders. However, arthrography is a time-consuming, minimally invasive procedure, which, although generally safe, it might carries some risks like hemorrhage and infection. Objectives: The aim of this work was to evaluate the diagnostic performance of MR arthrography (MRA) in the detection of shoulder disorders in patients having shoulder instability. Patients and methods: Between February 2017 and March 2021, 50 patients with a clinical diagnosis of shoulder instability were examined by MR arthrography. MR arthrographic finings including the different labral tears, rotator-cuff tears (RCTs) and Hill–Sachs lesions were recognized and compared to surgical arthroscope ‘ the gold standard’. Sensitivity, specificity, accuracy, PPV and NPV were calculated for MR arthrography. Results: MRA showed sensitivity and specificity of about 90% for the detection of classic Bankart lesions, sensitivity of 91.8 and specificity of 100%, for detecting bony Bankart lesions, sensitivity and specificity of 91.6 %, and 100% for the detection of SLAP lesions. The sensitivity and specificity for the detection of Hill-Sachs were 92.31%, 100% respectively; the sensitivity and specificity in the detection of RCTs were 95.24% and 100%. Conclusion: MR arthrography has a high diagnostic performance in the detection of different labral tears. RCTs (in particular partial thickness RCTs) and Hill–Sachs lesions.
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spelling doaj.art-2be822abfabe4e8784e3847e887d969b2022-12-21T23:33:49ZengSouth Valley University, Faculty of MedicineSVU - International Journal of Medical Sciences2735-427X2636-34022021-08-0142313326 https://dx.doi.org/10.21608/svuijm.2021.96089.1221Role of MR arthrography In Assessment of Glenohumeral InstabilityHamdan Abdelhameed Aly0 Mohammad Hassan Alkousy1Khaled Fawzy Zaky2Mohammad Tharwat Mahmoud Solyman3Department of Radio-diagnosis, Faculty of Medicine, Sohag University, Sohag, EgyptDepartment of Radio-diagnosis, Faculty of Medicine, Sohag University, Sohag, EgyptDepartment of Radio-diagnosis, Faculty of Medicine, Sohag University, Sohag, EgyptDepartment of Radio-diagnosis, Faculty of Medicine, Sohag University, Sohag, EgyptBackground: The glenohumeral joint has a unique structure which allows for the widest range of motion among all joints in the human body; however this unfortunately makes the joint inherently unstable. Various imaging techniques are available for assessment of shoulder joint abnormalities. Magnetic resonance arthrography is considered the best modality for the assessment of disorders related to shoulder instability. The injection of para magnetic contrast solution into the joint cavity induced distension of the capsule allowing separation of the intra articular structures and beret visualization of shoulder disorders. However, arthrography is a time-consuming, minimally invasive procedure, which, although generally safe, it might carries some risks like hemorrhage and infection. Objectives: The aim of this work was to evaluate the diagnostic performance of MR arthrography (MRA) in the detection of shoulder disorders in patients having shoulder instability. Patients and methods: Between February 2017 and March 2021, 50 patients with a clinical diagnosis of shoulder instability were examined by MR arthrography. MR arthrographic finings including the different labral tears, rotator-cuff tears (RCTs) and Hill–Sachs lesions were recognized and compared to surgical arthroscope ‘ the gold standard’. Sensitivity, specificity, accuracy, PPV and NPV were calculated for MR arthrography. Results: MRA showed sensitivity and specificity of about 90% for the detection of classic Bankart lesions, sensitivity of 91.8 and specificity of 100%, for detecting bony Bankart lesions, sensitivity and specificity of 91.6 %, and 100% for the detection of SLAP lesions. The sensitivity and specificity for the detection of Hill-Sachs were 92.31%, 100% respectively; the sensitivity and specificity in the detection of RCTs were 95.24% and 100%. Conclusion: MR arthrography has a high diagnostic performance in the detection of different labral tears. RCTs (in particular partial thickness RCTs) and Hill–Sachs lesions.https://svuijm.journals.ekb.eg/article_197400.htmlmr arthrogram; arthroscope; rotator cuff; tears; hill; sach's lesions
spellingShingle Hamdan Abdelhameed Aly
Mohammad Hassan Alkousy
Khaled Fawzy Zaky
Mohammad Tharwat Mahmoud Solyman
Role of MR arthrography In Assessment of Glenohumeral Instability
SVU - International Journal of Medical Sciences
mr arthrogram; arthroscope; rotator cuff; tears; hill; sach's lesions
title Role of MR arthrography In Assessment of Glenohumeral Instability
title_full Role of MR arthrography In Assessment of Glenohumeral Instability
title_fullStr Role of MR arthrography In Assessment of Glenohumeral Instability
title_full_unstemmed Role of MR arthrography In Assessment of Glenohumeral Instability
title_short Role of MR arthrography In Assessment of Glenohumeral Instability
title_sort role of mr arthrography in assessment of glenohumeral instability
topic mr arthrogram; arthroscope; rotator cuff; tears; hill; sach's lesions
url https://svuijm.journals.ekb.eg/article_197400.html
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