Title: Imaging In Shoulder Joint Diseases
Authors: Dr Akhand Pratap Singh, Dr Dinesh Kumar, Dr Arvind Srivastav, Dr Ashish Verma, Dr Ramvilas Nag, Dr Suman Chaurasia
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.21
Abstract
Background: MRI of the shoulder continues to develop as an important tool in the assessment of joint and soft tissue pathology. The aim of this study is a prospective descriptive compilation of the role of available imaging modalities in evaluation of different clinical syndromes referable to shoulder joint.
Material & Methods: The Prospective observational study was carried out on 50 patients in the Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi during period of July 2013 to July 2015. Ethical approval was obtained from the local ethics committee. Informed consent was obtained from each patient, prior to their enrolment in this study. Full history was taken especially about any previous operative procedure, any drug allergy or any absolute contraindication for MRI.
Results: The mean age was 24 years and maximum number of patients affected belong to the age group of 21-30 years. There was increased incidence of SLAP lesion in patients having Buford complex (50%) as compared to patients who were not having Buford complex. An initial suspicion of osteochondritis dissecans existed on MRI but was confirmed only with the visualization of bony fragment on MR arthrography. CT scan, which was performed for confirmation, showed the loose body as well.
Conclusion: MRI and MR Arthrography because of its excellent soft tissue contrast, imaging capability in any desired plane is an ideal modality of choice. In the present study, it could be deciphered that MRI was superior to ultrasound for diagnosing rotator cuff tendon tear. The MR Imaging has effectively replaced all other tests in evaluation of shoulder problems.
Key Words: Shoulder joint, MRI, Rotator cuff pathology, MR Arthrography.
References
1. Stecco, A. Castagna and A Carriero . J Orthop Traumatol. Virtual MR arthroscopy of the shoulder: image gallery with arthroscopic correlation of major pathologies of of shoulder instability2008 Dec; 9(4): 187–193.
2. Gusmer PB, Potter HG, Schatz JA, Wickiewicz TL, Altchek DW, O'Brien SJ, Warren RFRadiology.Labral injuries: accuracy of detection with unenhanced MR imaging of the shoulder.1996 Aug;200(2):519-24
3. MA Zacchilli et al. Epidemiology of Shoulder Dislocations Presenting to Emergency Departments in the United States. J Bone Joint Surg Am : 2010; 92 (3), 542-549.
4. Bashir J, Sherman A, Lee H, Kaplan L, Hare JM. Mesenchymal stem cell therapies in the treatment of musculoskeletal diseases. PM R. 2014;6(1):61–9.
5. Lenza M1, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NC, Faloppa F 2013 MR Arthrography of the Labral Capsular Ligamentous Complex in the Shoulder: Imaging Variations and Pitfalls 2000.
6. de Jesus JO, Parker L, Frangos AJ, et al:Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR Am J Roentgenol, 2009;192:1701–1707.
SJ Kim, SH Kim, SK Lee, JW Seo, YM Chun: Arthroscopic repair of massive contracted rotator cuff tears: aggressive release with anterior and posterior interval slides do not improve cuff healing and integrity: J Bone Joint Surg Am, 2013,
8. Cluett J., Hill-Sachs Injury: Damage to the shoulder joint as result of dislocation, Orthopedics, 2013.
9. Waldt S, Burkart A, Imhoff AB, Bruegel M, Rummeny EJ, Woertler K. Anterior shoulder instability: Accuracy of MR arthrography in the classification of anterior labroligamentous injuries. Radiol. 2005;237:578–83
10. Palmer H, Jhankaria B, Maheshwari M, Singrakhia M, Shanbag S, Chawla A, Deshpande SJ Postgrad Med.Magnetic resonance arthrography in recurrent anterior shoulder instability as compared to arthroscopy: a prospective comparative study. 2002 Oct-Dec;48(4):270-3.
11. Bents RT, Skeete KD J Shoulder Elbow Surg. The correlation of the Buford complex and SLAP lesions 2005 Nov-Dec; 14(6):565-9.