MR evaluation of synovial injury in shoulder trauma

被引:4
作者
Chalian M. [1 ]
Soldatos T. [1 ]
Faridian-Aragh N. [1 ]
Andreisek G. [2 ]
McFarland E.G. [3 ]
Carrino J.A. [1 ]
Chhabra A. [1 ]
机构
[1] Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21287
[2] Department of Radiology, University Hospital Zurich, 8091 Zurich
[3] Division of Orthopedic Surgery, Johns Hopkins Hospital, Baltimore, MD
关键词
Bursa; Ganglion; Magnetic resonance imaging; Shoulder; Synovial injury; Trauma;
D O I
10.1007/s10140-011-0973-4
中图分类号
学科分类号
摘要
The purpose of this study was to determine magnetic resonance imaging (MRI) findings relevant to synovial injury of the shoulder in patients with and without acute shoulder trauma. Three hundred and nine consecutive shoulder MRI studies (185-male, 124-female, 50± 15 years old) were retrospectively evaluated for findings suggestive of synovial injury including rupture and/or diverticulum of the joint capsule, bursa, and biceps tendon sheath (BTS), ganglion/synovial cyst, geyser phenomenon, and sequel of previous shoulder dislocation (Hill-Sachs deformity). Patients with one or more of these findings were included in the MR-positive group, whereas the remaining subjects were used as MR negatives. Based on their medical records, patients were also divided into trauma and non-trauma groups, and statistical analysis was performed to evaluate the association between the aforementioned MRI findings and history of shoulder trauma. Fifty-six patients were included in the MR-positive group and 253 in the MR-negative group. In MR-positive group, the incidence of capsular rupture (CR) and subacromial/ subdeltoid (SASD) bursal rupture was higher in trauma patients, whereas the incidence of BTS diverticulum and ganglion cyst was higher in subjects without trauma. Significant association was found between the history of acute trauma and CR, SASD bursal rupture, BTS rupture, and Hill-Sachs deformity. In shoulder MR examination, presence of CR and/or SASD bursal rupture is strongly suggestive of acute shoulder trauma. In addition, BTS rupture and Hill-Sachs deformity are more prevalent in patients with acute shoulder trauma. The presence of these features should alert MRI readers to assess for additional trauma-related internal derangements, if a respective history has not been provided. © Am Soc Emergency Radiol 2010.
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页码:395 / 402
页数:7
相关论文
共 24 条
  • [1] Wofford J.L., Mansfield R.J., Watkins R.S., Patient characteristics and clinical management of patients with shoulder pain in U.S. primary care settings: Secondary data analysis of the National Ambulatory Medical Care Survey, BMC Musculoskelet Disord, 6, (2005)
  • [2] Rutten M.J., Collins J.M., De Waal Malefijt M.C., Kiemeney L.A., Jager G.J., Unsuspected sonographic findings in patients with posttraumatic shoulder complaints, J Clin Ultrasound, 38, pp. 457-465, (2010)
  • [3] Connell D.A., Potter H.G., Magnetic resonance evaluation of the labral capsular ligamentous complex: A pictorial review, Australasian Radiology, 43, 4, pp. 419-426, (1999)
  • [4] Shah R.R., Haghpanah S., Elovic E.P., Et al., MRI findings in the painful poststroke shoulder, Stroke, 39, pp. 1808-1813, (2008)
  • [5] Massengill A.D., Seeger L.L., Yao L., Et al., Labrocapsular ligamentous complex of the shoulder: Normal anatomy, anatomic variation, and pitfalls of MR imaging and MR arthrography, Radiographics, 14, pp. 1211-1223, (1994)
  • [6] Parker B.J., Zlatkin M.B., Newman J.S., Rathur S.K., Imaging of shoulder injuries in sports medicine: Current protocols and concepts, Clin Sports Med, 27, pp. 579-606, (2008)
  • [7] Matsuzaki S., Yoneda M., Kobayashi Y., Fukushima S., Wakitani S., Dynamic enhanced MRI of the subacromial bursa: Correlation with arthroscopic and histological findings, Skeletal Radiology, 32, 9, pp. 510-520, (2003)
  • [8] Gray H., Lewis W.H., Gray's Anatomy of the Human Body, (2000)
  • [9] Bureau N.J., Dussault R.G., Keats T.E., Imaging of bursae around the shoulder joint, Skeletal Radiology, 25, 6, pp. 513-517, (1996)
  • [10] Grainger A.J., Tirman P.F.J., Elliott J.M., Kingzett-Taylor A., Steinbach L.S., Genant H.K., MR anatomy of the subcoracoid bursa and the association of subcoracoid effusion with tears of the anterior rotator cuff and the rotator interval, American Journal of Roentgenology, 174, 5, pp. 1377-1380, (2000)