First-time shoulder dislocation: High prevalence of labral injury and age-related differences revealed by MR arthrography

被引:87
作者
Antonio, Gregory E.
Griffith, James F.
Yu, Alfred B.
Yung, Patrick S. H.
Chan, Kai Ming
Ahuja, Anil T.
机构
[1] Chinese Univ Hong Kong, Dept Diagnost Radiol & Organ Imaging, Shatin, Hong Kong, Peoples R China
[2] Chinese Univ Hong Kong, Dept Orthopaed & Traumatol, Sha Tin 100083, Peoples R China
关键词
MR arthrography; shoulder; dislocation; first time;
D O I
10.1002/jmri.21092
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To evaluate abnormalities and age-related differences after first-time shoulder dislocation Materials and Methods: MRA images of first-time dislocators were assessed for labral ligamentous-capsular / rotator cuff abnormalities and analyzed the age-related differences (< and >= 30 years old). Results: Sixty-six patients (34 <30 years old vs. 32 >= 30 years; 51 males; all anterior dislocations) were imaged. Forty-eight patients (73%) showed anteroinferiro labral avulsion, consisting of: 6% (4/34 vs. 0.32) Perthes: 23% (8/34 vs. 7/32) free ALPSA (anterior labrum periosteal sleeve avulsion) lesion): 6% (1/34 vs. 3/32) adherent ALPSA; 23% (9/34 vs. 6/32) Bankart: 14% (5/34 vs. 4/32) inferiorly displaced avulsed labrum: 2% (1/34 vs. 0/32) GLAD. Extensive labral detachment (extended above 3 o'clock position) was present in 31% (11/28 vs. 4/20). There were 14$ (6/34 vs. 3/32) superior labrum anterior posterior (SLAP) lesion: 27% (1/34 vs. 17/34) rotator cufftendon tear; 71% (25/34 vs. 22/32) Hill-Sachs defect. Yound patients were more likely to have extensive labral avulsions (P = 0.054), but less likely to have rotator cuff tears (P < 0.001). Conclusion: A high prevalence and wide variety of labral avulsions after first-time shoulder dislocation, especially adherent ALPSA, inferiorly displaced avulsed labrum, or GLAD lesion, may influence treatment choice and outcome, suggesting a role for early MRA to assist in treatment triage.
引用
收藏
页码:983 / 991
页数:9
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