A comparison of magnetic resonance arthrography and arthroscopic findings in the assessment of anterior shoulder dislocations
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The aim of this study is to establish the sensitivity and specificity of MRA in the investigation of patients with traumatic anterior shoulder dislocations.
Materials and methods
A retrospective analysis of consecutive patients undergoing both magnetic resonance arthrography and arthroscopic assessment after a traumatic anterior shoulder dislocation between January 2011 and 2014 was performed. Demographic data were collected from electronic records. Images were interpreted by 8 musculoskeletal radiologists and patients were treated by 8 consultant orthopaedic surgeons. Arthroscopic findings were obtained from surgical notes and these findings were used as a reference for MRA. The sensitivity, specificity, and positive predictive value were calculated for the different injuries.
Sixty-nine patients underwent both an MRA and shoulder arthroscopy during the study period; however, clinical notes were unavailable in 9 patients. Fifty-three patients (88 %) were male, the mean age was 28 years (range 18 to 50) and 16 subjects (27 %) had suffered a primary dislocation. The overall sensitivity and specificity of MRA to all associated injuries was 0.9 (CI 0.83–0.95) and 0.94 (CI 0.9–0.96) retrospectively. The lowest sensitivity was seen in osseous Bankart 0.8 (CI 0.44–0.96) and superior labral tear (SLAP) lesions 0.5 (CI 0.14–0.86). The overall positive predictive value was 0.88 (CI 0.76–0.91) with the lowest values found in rotator cuff 0.4 (CI 0.07–0.83) and glenohumeral ligament (GHL) lesions 0.29 (CI 0.05–0.7).
Magnetic resonance angiography has a high sensitivity when used to identify associated injuries in shoulder dislocation, although in 8 patients (13 %) arthroscopy identified an additional injury. The overall agreement between MRA and arthroscopic findings was good, but the identification of GHL and rotator cuff injuries was poor.
KeywordsShoulder Dislocation Instability Magnetic resonance imaging Arthroscopy
Conflict of interest
The authors declare that they have no conflicts of interest and that no funding was received during the production of this manuscript.
- 6.Kralinger F, Gloser W, Wischatta R, Wambacher M, Sperner G. Predicting recurrence after primary anterior shoulder dislocation. Am J Sports Med. 2002;20:41–8.Google Scholar
- 16.Jana M, Srivastava DN, Sharma R, et al. Magnetic resonance arthrography for assessing severity of glenohumeral labroligamentous lesions. J Orthop Surg (Hong Kong). 2012;20(2):230–5.Google Scholar
- 18.Van der Veen HC, Collins JP, Rijk PC. Value of magnetic resonance arthrography in post-traumatic anterior shoulder instability prior to arthroscopy: a prospective evaluation of MRA versus arthroscopy. Arch Orthop Trauma Surg. 2012;132(3):371–5.Google Scholar
- 27.Connolly KP, Schwartzberg RS, Reuss B, Crumble Jr D, Homan BM. Sensitivity and specificity of noncontrast magnetic resonance imaging reports in the diagnosis of type-II superior labral anterior-posterior lesions in the community setting. J Bone Joint Surg Am. 2013;95(4):308–13.CrossRefPubMedGoogle Scholar