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Radiographic Evaluation of Patients with Anterior Shoulder Instability

  • Management of Anterior Shoulder Instability (X Li, section editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

Injuries to the labrum, joint capsule (in particular the inferior glenohumeral ligament), cartilage, and glenoid periosteum are associated with anterior shoulder instability. The goal of this review is to provide common radiographic images and findings in patients with anterior shoulder instability. Furthermore, we will demonstrate the best methods for measuring anterior glenoid bone loss.

Recent Findings

Magnetic resonance (MR) imaging is highly relied upon for evaluating anterior shoulder instability and can diagnose soft tissue injuries with high sensitivity. While 3D computed tomography (CT) scan has been considered the optimal tool for evaluating osseous defects, certain MR imaging sequences have been shown to have similar diagnostic accuracy. Repair of Bankart lesions is critical to stabilizing the shoulder, and in the recent years, there has been an increasing focus on imaging to accurately characterize and measure glenoid bone loss to properly indicate patients for either arthroscopic repair or anterior bony reconstruction. Furthermore, Hill-Sachs lesions are commonly seen with shoulder instability, and importance must be placed on measuring the size and depth of these lesions along with possible engagement, as these factors will dictate management.

Summary

The labral-ligamentous complex and rotator cuff are primary stabilizers of the shoulder. With anterior shoulder instability, the labrum is frequently injured. MRI with an arthrogram or provocative maneuvers is the gold standard for diagnosis. Various imaging modalities and methods can be performed to identify and measure Bankart and Hill-Sachs lesions, which can then be used for surgical planning and treating shoulder instability.

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Authors and Affiliations

  1. Department of Radiology, Boston University School of Medicine, FGH Building, 820 Harrison Ave., Boston, MA, 02118, USA

    Andrew J. Kompel, Ali Guermazi & Akira M. Murakami

  2. Department of Orthopaedic Surgery, Boston University School of Medicine, 850 Harrison Avenue–Dowling 2 North, Boston, MA, 02118, USA

    Xinning Li

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  1. Andrew J. Kompel
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Correspondence to Akira M. Murakami.

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Conflict of Interest

Andrew J. Kompel and Akira M. Murakami declare that they have no conflict of interest.

Xinning Li is on the board of JoMI and has equity in the company. Ali Guermazi reports personal fees from BICL, LLC, Pfizer, MerckSerono, TissueGene, OrthoTrophix, Sanofi, GE, and AstraZeneca, outside of the submitted work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Management of Anterior Shoulder Instability

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Kompel, A.J., Li, X., Guermazi, A. et al. Radiographic Evaluation of Patients with Anterior Shoulder Instability. Curr Rev Musculoskelet Med 10, 425–433 (2017). https://doi.org/10.1007/s12178-017-9433-4

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