Skip to main content
SpringerLink
Log in

3D-MR vs. 3D-CT of the shoulder in patients with glenohumeral instability

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To determine whether 3D-MR osseous reformats of the shoulder are equivalent to 3D-CT osseous reformats in patients with glenohumeral instability.

Materials and methods

Patients with glenohumeral instability, who were to be imaged with both CT and MRI, were prospectively selected. CT and MR were performed within 24 h of one another on 12 shoulders. Each MR study included an axial 3D isotropic VIBE sequence. The image data from the isotropic VIBE sequence were post-processed using subtraction and 3D software. CT data were post-processed using 3D software. The following measurements were obtained for both 3D-CT and 3D-MR post-processed images: height and width of the humeral head and glenoid, Hill-Sachs size and percent humeral head loss (if present), size of glenoid bone loss and percent glenoid bone loss (if present). Paired t-tests and two one-sided tests for equivalence were used to assess the differences between imaging modalities and equivalence.

Results

The measurement differences from the 3D-CT and 3D-MR post-processed images were not statistically significant. The measurement differences for humeral height, glenoid height and glenoid width were borderline statistically significant; however, using any adjustment for multiple comparisons, this failed to be significant. Using an equivalence margin of 1 mm for measurements and 1.5% for percent bone loss, the 3D-MR and 3D-CT post-processed images were equivalent.

Conclusion

Three-dimensional-MR osseous models of the shoulder using a 3D isotropic VIBE sequence were equivalent to 3D-CT osseous models, and the differences between modalities were not statistically significant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Bishop JY, Jones GL, Rerko MA, et al. 3-D CT is the most reliable imaging modality when quantifying glenoid bone loss. Clin Orthop Relat Res. 2013;471:1251–6.

    Article  PubMed  Google Scholar 

  2. Rerko MA, Pan X, Donaldson C, et al. Comparison of various imaging techniques to quantify glenoid bone loss in shoulder instability. J Shoulder Elb Surg. 2013;22:528–38.

    Article  Google Scholar 

  3. Gyftopoulos S, Yemin A, Mulholland T, et al. 3DMR reconstructions of the shoulder using a gradient-echo based two-point Dixon reconstruction: a feasibility study. Skelet Radiol. 2013;42:347–52.

    Article  Google Scholar 

  4. Gyftopoulos S, Beltran LS, Yemin A, et al. Use of 3D MR reconstructions in the evaluation of glenoid bone loss: a clinical study. Skelet Radiol. 2014;43:213–8.

    Article  Google Scholar 

  5. Kwon YW, Powell KA, Yum JK, Brems JJ, Iannotti JP. Use of three-dimensional computed tomography for the analysis of the glenoid anatomy. J Shoulder Elb Surg. 2005;14:85–90.

    Article  Google Scholar 

  6. Bokor DJ, O’Sullivan MD, Hazan GJ. Variability of measurement of glenoid version on computed tomography scan. J Shoulder Elb Surg. 1999;8:595–8.

    Article  CAS  Google Scholar 

  7. Gyftopoulos S, Hasan S, Bencardiono J, et al. Diagnostic accuracy of MRI in the measurement of glenoid bone loss. AJR. 2012;199:873–8.

    Article  PubMed  Google Scholar 

  8. Provencher MT, Bhatia S, Ghodadra NS, et al. Recurrent shoulder instability: current concepts for evaluation and management of glenoid bone loss. J Bone Joint Surg Am. 2010;92 Suppl 2:133–51.

    Article  PubMed  Google Scholar 

  9. Walker E, Nowacki AS. Understanding equivalence and noninferiority testing. J Gen Intern Med. 2011;26(2):192–6.

    Article  PubMed  Google Scholar 

  10. Burkhart SS, Danaceau SM. Articular arc length mismatch as a cause of failed Bankart repair. Arthroscopy. 2000;16:740–4.

    Article  CAS  PubMed  Google Scholar 

  11. Chen AL, Hunt SA, Hawkins RJ, Zuckerman JD. Management of bone loss associated with recurrent anterior glenohumeral instability. Am J Sports Med. 2005;33:912–25.

    Article  PubMed  Google Scholar 

  12. Piasecki DP, Verma NN, Romeo AA, Levine WN, Bach Jr BR, Provencher MT. Glenoid bone deficiency in recurrent anterior shoulder instability: diagnosis and management. J Am Acad Orthop Surg. 2009;17:482–93.

    Article  PubMed  Google Scholar 

  13. Latarjet M. Treatment of recurrent dislocation of the shoulder [in French]. Lyon Chir. 1954;49:994–7.

    CAS  PubMed  Google Scholar 

  14. Helfet AJ. Coracoid transplantation for recurring dislocation of the shoulder. J Bone Joint Surg (Br). 1958;40:198–202.

    Google Scholar 

  15. Warner JJ, Gill TJ, O’Hollerhan JD, Pathare N, Millett PJ. Anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with glenoid deficiency using an autogenous tricortical iliac crest bone graft. Am J Sports Med. 2006;34:205–12.

    Article  PubMed  Google Scholar 

  16. Provencher MT, Ghodadra N, LeClere L, Solomon DR, Romeo AA. Anatomic osteochondral glenoid reconstruction for recurrent glenohumeral instability with glenoid deficiency using a distal tibia allograft. Arthroscopy. 2009;25:446–52.

    Article  PubMed  Google Scholar 

  17. Taylor D, Arciero R. Pathologic changes associated with shoulder dislocations. Am J Sports Med. 1997;25:306–11.

    Article  CAS  PubMed  Google Scholar 

  18. Miniaci A, Berlet G. Recurrent anterior instability following failed surgical repair: allograft reconstruction of large humeral head defects. J Bone Joint Surg (Br). 2001;83:19–20.

    Google Scholar 

  19. Wolf EM, Pollack M, Smalley C. Hill-Sachs “remplissage”: an arthroscopic solution for the engaging Hill-Sachs lesion. Arthroscopy. 2007;38:302–7.

    Google Scholar 

  20. Gyftopoulos S, Albert M, Recht MP. Osseous injuries associated with anterior shoulder instability: what the radiologist should know. AJR. 2013;202:W541–50.

    Article  Google Scholar 

  21. Rowe CR, Zarins B, Ciullo JV. Recurrent anterior dislocation of the shoulder after surgical repair: apparent causes of failure and treatment. J Bone Joint Surg Am. 1984;66:159–68.

    Article  CAS  PubMed  Google Scholar 

  22. Bühler M, Gerber C. Shoulder instability related to epileptic seizures. J Shoulder Elb Surg. 2002;11:339–44.

    Article  Google Scholar 

  23. Miniaci A, Berlet G, Hand C, Lin A. Segmental humeral head allografts for recurrent anterior instability of the shoulder with large Hill-Sachs defects; a two to eight year follow up. J Bone Joint Surg (Br). 2008;90 suppl 1:86.

    Google Scholar 

  24. Bock P, Kluger R, Hintermann B. Anatomical reconstruction for reverse Hill-Sachs lesions after posterior locked shoulder dislocation fracture: a case series of six patients. Arch Orthop Trauma Surg. 2007;127:543–8.

    Article  PubMed  Google Scholar 

  25. Gerber C, Lambert SM. Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder. J Bone Joint Surg Am. 1996;78:376–82.

    Article  CAS  PubMed  Google Scholar 

  26. Miniaci A, Gish MW. Management of anterior glenohumeral instability associated with large Hill-Sachs defects. Tech Should Elbow Surg. 2004;5:170–5.

    Article  Google Scholar 

  27. Sekiya JK, Wickwire AC, Stehle JH, Debski RE. Hill-Sachs defects and repair using osteoarticular allograft transplantation biomechanical analysis using a joint compression model. Am J Sports Med. 2009;37:2459–66.

    Article  PubMed  Google Scholar 

  28. Sugaya H, Moriishi J, Dohi M, et al. Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am. 2003;85-A:878–84.

    Article  PubMed  Google Scholar 

  29. Taylor DC, Arciero RA. Pathologic changes associated with shoulder dislocations: arthroscopic and physical examination findings in first time, traumatic anterior dislocations. Am J Sports Med. 1997;25:306–11.

    Article  CAS  PubMed  Google Scholar 

  30. Griffith JF, Antonio GE, Tong CW, Ming CK. Anterior shoulder dislocation: quantification of glenoid bone loss with CT. AJR. 2003;180:1423–30.

    Article  PubMed  Google Scholar 

  31. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000;16:677–94.

    Article  CAS  PubMed  Google Scholar 

  32. Boileau P, Villalbe M, Hery JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am. 2006;88:1755–63.

    PubMed  Google Scholar 

  33. Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect on anterioinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am. 2000;82:35–46.

    Article  CAS  PubMed  Google Scholar 

  34. Lo IK, Perten PM, Burkhart SS. The inverted pear glenoid: an indicator of significant glenoid bone loss. Arthroscopy. 2004;20:169–74.

    Article  PubMed  Google Scholar 

  35. Greis PE, Scuderi MG, Mohr A, Bachus KN, Burks RT. Glenohumeral articular contact areas and pressures following labral and osseous injury to the anteroinferior quadrant of the glenoid. J Shoulder Elb Surg. 2002;11:442–51.

    Article  Google Scholar 

  36. Lynch JR, Clinton JM, Dewing CB, Warme WJ, Matsen 3rd FA. Treatment of osseous defects associated with anterior shoulder instability. J Shoulder Elb Surg. 2009;18:317–28.

    Article  Google Scholar 

  37. Beran MC, Donaldson CT, Bishop JY. Treatment of chronic glenoid defects in the setting of recurrent anterior shoulder instability: a systematic review. J Shoulder Elb Surg. 2010;19:769–80.

    Article  Google Scholar 

  38. Bigliani LU, Newton PM, Steinmann SP, Connor PM, McIlveen SJ. Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med. 1998;26:41–5.

    CAS  PubMed  Google Scholar 

  39. Flatow EL, Warner JI. Instability of the shoulder: complex problems and failed repairs: Part I. Relevant biomechanics, multidirectional instability, and severe glenoid loss. Instr Course Lect. 1998;47:97–112.

    CAS  PubMed  Google Scholar 

  40. Ochoa Jr E, Burkhart SS. Glenohumeral bone defects in the treatment of anterior shoulder instability. Instr Course Lect. 2009;58:323–36.

    PubMed  Google Scholar 

  41. Yamamoto N, Itoi E, Abe H, Kikuchi K, Seki N, Minagawa H, et al. Effect of an anterior glenoid defect on anterior shoulder stability: a cadaveric study. Am J Sports Med. 2009;37:949–54.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Manitoba, Winnipeg, Canada

    Laurence Stillwater, James Koenig, Bruce Maycher & Michael Davidson

Authors
  1. Laurence Stillwater
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James Koenig
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bruce Maycher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laurence Stillwater.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stillwater, L., Koenig, J., Maycher, B. et al. 3D-MR vs. 3D-CT of the shoulder in patients with glenohumeral instability. Skeletal Radiol 46, 325–331 (2017). https://doi.org/10.1007/s00256-016-2559-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-016-2559-4

Keywords

Search

Navigation