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A prospective comparison of computerized arthrotomography and magnetic resonance imaging of the glenohumeral joint

Department of Orthopaedic Surgery, Letterman Army Medical Center, Presidio of San Francisco

Steve A. Petersen, MD

Department of Orthopaedic Surgery, Letterman Army Medical Center, Presidio of San Francisco

Christian Neumann, MD

Department of Radiology, University of California Medical Center, San Francisco, California

Lynn Steinbach, MD

Department of Radiology, University of California Medical Center, San Francisco, California

Frank Morgan, MD

Department of Radiology, David Grant Air Force Medical Center, Travis Air Force Base, California

Twenty-five patients with shoulder instability or shoul der pain of undetermined etiology were prospectively evaluated with magnetic resonance imaging and com puterized arthrotomography. Actual lesions were de termined by arthroscopy or at the time of open surgical repair. The images obtained were interpreted independ ently by three radiologists blinded to both surgical results and the results of previous diagnostic tests. Sensitivity, specificity, and accuracy were determined for each imaging technique for a variety of pathologic entities, including anterior and posterior labral abnor malities, capsular redundancy, biceps-labral complex abnormalities, humeral head (Hill-Sachs) impression le sions, and glenohumeral loose bodies. Analysis of im aging techniques also included construction of receiver operator curves for labral abnormalities.

Magnetic resonance imaging showed better diagnos tic results in the evaluation of glenoid labral and humeral head impression lesions (P < 0.05). Both imaging tech niques were equally successful in identifying biceps- labral lesions and intraarticular loose bodies within the glenohumeral joint. Neither imaging technique was con sistent in the evaluation of capsular redundancy. Re ceiver operator curve analysis confirmed that magnetic resonance imaging was the more accurate imaging study in evaluating anterior and posterior glenoid labral abnormalities.

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				R. J. HERZOG Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Magnetic Resonance Imaging of the Shoulder*{{dagger}} J. Bone Joint Surg. Am., June 1, 1997; 79(6): 934 - 53. [Full Text]