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Anterior–inferior labral lesions of recurrent shoulder dislocation evaluated by MR arthrography in an adduction internal rotation (ADIR) position

 Ho-Taek Song  ;  Yong-Min Huh  ;  Sungjun Kim  ;  Sung Ah Lee  ;  Sung-Jae Kim  ;  Kyoo-Ho Shin  ;  Jin-Suck Suh 
 Journal of Magnetic Resonance Imaging, Vol.23(1) : 29-35, 2006 
Journal Title
 Journal of Magnetic Resonance Imaging 
Issue Date
Adolescent ; Adult ; Cartilage, Articular/injuries* ; Diagnosis, Differential ; Female ; Humans ; Joint Instability/classification* ; Ligaments, Articular/injuries* ; Magnetic Resonance Imaging/methods* ; Male ; Posture* ; ROC Curve ; Recurrence ; Retrospective Studies ; Rotation ; Sensitivity and Specificity ; Shoulder Dislocation/diagnosis* ; Shoulder Joint/injuries* ; Statistics, Nonparametric ; Wounds and Injuries/classification*
MR arthrography ; shoulder ; ALPSA ; internal rotation ; labral lesion
PURPOSE: To introduce and evaluate the usefulness of the adduction internal rotation (ADIR) position in MR arthrography for discriminating the following subtypes of Bankart lesions: classic Bankart lesions, anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions, and Perthes lesions. MATERIALS AND METHODS: The study group consisted of 25 patients who had been referred for MR arthrography of the shoulder and then underwent arthroscopy due to recurrent episodes of shoulder dislocation. MR arthrography was performed in three different positions: neutral, abduction external rotation (ABER), and ADIR. The authors evaluated the statistical significance of the method's discriminative diagnostic ability for the subtypes of Bankart lesions according to the position changes. RESULTS: Twenty-three patients had the following single or complex labral lesions: classic Bankart (N = 8), ALPSA (N = 3), complex classic Bankart/ALPSA (N = 8), and complex ALPSA/Perthes (N = 4). Two patients had no visible anteroinferior labral lesions. The performance of ADIR positioning for differentiating ALPSA lesions was superior to the neutral or ABER positioning. The difference of the discriminative lesion detection ability was statistically significant (P <.01) only for detecting ALPSA lesions in the ADIR position. CONCLUSION: MR arthrography in the ADIR position provides high accuracy for the diagnosis of ALPSA lesions, and complements routine MR arthrography when used to diagnose labroligamentous lesions in patients with recurrent shoulder dislocations.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Jae(김성재)
Kim, Sungjun(김성준) ORCID logo https://orcid.org/0000-0002-7876-7901
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Song, Ho Taek(송호택) ORCID logo https://orcid.org/0000-0002-6655-2575
Shin, Kyoo Ho(신규호)
Huh, Yong Min(허용민) ORCID logo https://orcid.org/0000-0002-9831-4475
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