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La radiologia medica

, Volume 118, Issue 1, pp 112–122 | Cite as

Lesions of the biceps pulley as cause of anterosuperior impingement of the shoulder in the athlete: potentials and limits of MR arthrography compared with arthroscopy

  • A. BarileEmail author
  • G. Lanni
  • L. Conti
  • S. Mariani
  • V. Calvisi
  • A. Castagna
  • F. Rossi
  • C. Masciocchi
Musculoskeletal Radiology / Radiologia Muscolo-Scheletrica

Abstract

Purpose

This study aimed to evaluate the diagnostic possibilities of MR arthrography in the correct identification of complex tears of the biceps pulley and their possible correlation with anterosuperior impingement (ASI) development.

Materials and methods

MR arthrography examinations of 23 athletes with clinical suspicion of ASI were reviewed. All examinations were obtained with a 1.5-T unit (Signa Horizon, GE Healthcare). The shoulders were studied with a dedicated surface coil with the patient’s arm in the neutral position and in internal and external rotation. In five patients, images in abduction-external rotation (ABER) were obtained. Within 2 month after MR arthrography, the athletes underwent arthroscopic surgery.

Results

MR arthrography images showed a spectrum of tears that, according to the Habermeyer classification, were subdivided into four groups: type 1 in three patients; type 2 in five; type 3 in seven; type 4 in eight. At arthroscopic evaluation, one patient presented type 1 lesion, five type 2, five type 3 and ten type 4. During arthroscopic dynamic manoeuvres, ASI signs were observed in three patients with type 3 lesion and in ten with type 4 lesion.

Conclusions

MR arthrography is the imaging modality of choice for evaluating lesions of the rotator interval structures, and only complex lesions of the biceps pulley are related to the development of ASI.

Keywords

MRI Arthro-MRI Shoulder internal impingement Anterosuperior impingement Shoulder 

Lesioni della puleggia bicipitale come causa di impingement anterosuperiore di spalla nello sportivo: potenzialità e limiti dell’artro-RM e confronto artroscopico

Riassunto

Obiettivi

Scopo del presente lavoro è la valutazione delle potenzialità dell’artro-risonanza magnetica (RM) nell’identificazione di lesioni complesse della puleggia bicipitale e correlazione con lo sviluppo di impingement antero-superiore (IAS).

Materiali e metodi

Sono stati revisionati gli esami artro-RM di 23 atleti con il sospetto clinico di IAS. L’esame è stato eseguito con magnete 1,5 tesla; la spalla è stata studiata con bobina dedicata con arto in condizioni basali ed in intra-extrarotazione. In 5 casi sono state effettuate acquisizioni in abduzione ed extrarotazione (ABER). Gli atleti sono stati sottoposti ad artroscopia entro i due mesi successivi.

Risultati

Sulla base dei reperti RM sono stati individuati 4 pattern lesionali principali secondo Habermeyer. All’esame artro-RM sono state riscontrate 3 lesioni di tipo 1, 5 lesioni di tipo 2, 7 lesioni di tipo 3 e 8 lesioni di tipo 4. L’artroscopia ha confermato una lesione di tipo 1, 5 lesioni di tipo 2, 5 lesioni di tipo 3 e 10 lesioni di tipo 4. Alle manovre dinamiche artroscopiche 3 lesioni di tipo 3 e 10 lesioni di tipo 4 presentavano segni compatibili con IAS.

Conclusioni

L’artro-RM è risultata essere una metodica estremamente valida per la diagnosi delle lesioni dell’intervallo dei rotatori; sulla base della nostra esperienza, soltanto le lesioni complesse della puleggia bicipitale, sono correlate allo sviluppo di IAS.

Parole chiave

Risonanza magnetica Artroh-RM Impingement interno di spalla Impingement anterosuperiore Spalla 

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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • A. Barile
    • 1
    Email author
  • G. Lanni
    • 1
  • L. Conti
    • 1
  • S. Mariani
    • 1
  • V. Calvisi
    • 2
  • A. Castagna
    • 3
  • F. Rossi
    • 1
  • C. Masciocchi
    • 1
  1. 1.Dipartimento di RadiodiagnosticaUniversità degli Studi di L’Aquila, Ospedale S. Salvatore di CoppitoL’AquilaItaly
  2. 2.Cattedra di OrtopediaUniversità di L’AquilaL’AquilaItaly
  3. 3.Chirurgia della SpallaIstituto HumanitasMilanoItaly

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