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Shoulder MR arthrography of the posterior labrocapsular complex in overhead throwers with pathologic internal impingement and internal rotation deficit

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Abstract

Purpose

To determine if overhead-throwing athletes with internal impingement pain and internal rotation deficit have thickening of the posterior inferior labrocapsular complex on MR arthrogram images.

Materials and methods

This study was approved and a waiver of consent granted by our institutional review board. Twenty-six overhead-throwing athletes with internal impingement pain and internal rotation deficit, and 26 controls who had undergone MR arthrograms, were retrospectively examined. The MR studies were combined and read in a blind fashion. On an axial image through the posteroinferior glenoid rim, the readers measured the labral length, capsule-labrum length, and the posterior recess angle. A t-test was used to determine statistical significance.

Results

The mean labral length was 4.9 mm [standard deviation (SD) 1.4 mm] for the controls, and 6.4 mm (SD 1.6 mm) for the athletes (P = 0.001). The mean capsule-labrum length was 5.4 mm (SD 2.1 mm) for the controls, and 8.8 mm (SD 2.9 mm) for the athletes (P < 0.001). The mean posterior recess angle measured 65° (SD 27°) for the controls and 94° (SD 38°) for the athletes (P = 0.002).

Conclusions

Overhead-throwing athletes with internal impingement pain and internal rotation deficit tend to have a thicker labrum and a shallower capsular recess in the posterior inferior shoulder joint than do non-overhead-throwing athletes. In many, the posteroinferior capsule is also thickened. These MR findings should alert the radiologist to closely inspect the posterior cuff and posterosuperior labrum for the tears associated with internal impingement.

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References

  1. Tirman PFJ, Smith ED, Stoller DW, Fritz RC. Shoulder imaging in athletes. Semin Musculoskelet Radiol 2004; 8: 29–40.

    Article  Google Scholar 

  2. Sanders TG, Miller MD. A systematic approach to magnetic resonance imaging interpretation of sports medicine injuries of the shoulder. Am J Sports Med 2005; 33: 1088–1105.

    Article  Google Scholar 

  3. Ho CP. MR imaging of rotator interval, long biceps, and associated injuries in the overhead-throwing athlete. Magn Reson Imaging Clin North Am 1999; 7: 23–37.

    CAS  Google Scholar 

  4. Tuite MJ. MR imaging of sports injuries to the rotator cuff. Magn Reson Imaging Clin North Am 2003; 11: 207–220.

    Article  Google Scholar 

  5. Beltran J, Kim DHM. MR imaging of shoulder instability injuries in the athlete. Magn Reson Imaging Clin North Am 2003; 11: 221–238.

    Article  Google Scholar 

  6. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology part I: pathoanatomy and biomechanics. Arthroscopy 2003; 19: 404–420.

    Article  Google Scholar 

  7. Jobe CM. Posterior superior glenoid impingement: expanded spectrum. Arthroscopy 1995; 11: 530–536.

    Article  CAS  Google Scholar 

  8. Jobe CM. Superior glenoid impingement. Orthop Clin North Am 1997; 28: 137–143.

    Article  CAS  Google Scholar 

  9. Walch G, Boileau P, Noel E, Donnell ST. Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surgery 1992; 1: 238–245.

    Article  CAS  Google Scholar 

  10. Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM. Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med 2006; 34: 385–391.

    Article  Google Scholar 

  11. Tirman PF, Bost FW, Garvin GJ, Peterfy CG, Mall JC, Steinbach LS, et al. Posterosuperior glenoid impingement of the shoulder: findings at MR imaging and MR arthrography with arthroscopic correlation. Radiology 1994; 193: 431–436.

    Article  CAS  Google Scholar 

  12. Giaroli EL, Major NM, Higgins LD. MRI of internal impingement of the shoulder. AJR Am J Roentgenol 2005; 185: 925–929.

    Article  Google Scholar 

  13. Kaplan LD, McMahon PJ, Towers J, Irrgang JJ, Rodosky MW. Internal impingement: findings on magnetic resonance imaging and arthroscopic evaluation. Arthroscopy 2004; 20: 701–704.

    Article  Google Scholar 

  14. Kibler WB, Chandler TJ. Range of motion in junior tennis players participating in an injury risk modification program. J Sci Med Sport 2003; 6: 51–62.

    Article  CAS  Google Scholar 

  15. Ticker JB, Beim GM, Warner JJ. Recognition and treatment of refractory posterior capsular contracture of the shoulder. Arthroscopy 2000; 16: 27–34.

    Article  CAS  Google Scholar 

  16. Matsen FA, Arntz CT, Lippitt SB. Rotator cuff. In: Rockwood CA, Matsen FA, eds. The shoulder. Philadelphia: Saunders 1998; 755–839.

    Google Scholar 

  17. O’Brien SJ, Neves MC, Arnoczky SP, Rozbruck SR, Dicarlo EF, Warren RF, et al. The anatomy and histology of the inferior glenohumeral complex of the shoulder. Am J Sports Med 1990; 8: 449–456.

    Article  Google Scholar 

  18. Davis SJ, Teresi LM, Bradley WG, Ressler JA, Eto RT. Effect of arm rotation on MR imaging of the rotator cuff. Radiology 1991; 181: 265–268.

    Article  CAS  Google Scholar 

  19. Paley K, Jobe F, Pink M, Kvitne R, ElAttrache N. Arthroscopic findings in the overhand throwing athlete: evidence for posterior internal impingement of the rotator cuff. Arthroscopy 2000; 16: 35–40.

    Article  CAS  Google Scholar 

  20. Burkhart SS, Morgan CD. SLAP lesions in the overhead athlete. Orthop Clin North Am 2001; 32: 431–441.

    Article  CAS  Google Scholar 

  21. De Maeseneer M, Jaovisidha S, Jacobson JA, Tam W, Schils JP, Sartoris DJ, et al. The Bennett lesion of the shoulder. J Comput Assist Tomogr 1998; 22: 31–34.

    Article  Google Scholar 

  22. Ferrari JD, Ferrari DA, Coumas J, Pappas AM. Posterior ossification of the shoulder: the Bennett lesion. Etiology, diagnosis, and treatment. Am J Sports Med 1994; 22: 171–175.

    Article  CAS  Google Scholar 

  23. Harper KW, Helms CA, Haystead CM, Higgins LD. Glenoid dysplasia: incidence and association with posterior labral tears as evaluated on MRI. AJR Am J Roentgenol 2005; 184: 984–988.

    Article  Google Scholar 

  24. Weishaupt D, Zanetti M, Nyffeler RW, Gerber C, Hodler J. Posterior glenoid rim deficiency in recurrent (atraumatic) posterior shoulder instability. Skeletal Radiol 2000; 29: 204–210.

    Article  CAS  Google Scholar 

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Correspondence to Michael J. Tuite.

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Tuite, M.J., Petersen, B.D., Wise, S.M. et al. Shoulder MR arthrography of the posterior labrocapsular complex in overhead throwers with pathologic internal impingement and internal rotation deficit. Skeletal Radiol 36, 495–502 (2007). https://doi.org/10.1007/s00256-007-0278-6

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  • DOI: https://doi.org/10.1007/s00256-007-0278-6

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