Abstract
Objective
Imaging the shoulder in the position of flexion, adduction, and internal rotation (FADIR) may be useful in characterizing lesions of the posteroinferior labrum. The purpose of this preliminary study is to illustrate the diagnostic utility of FADIR positioning in the assessment and characterization of posteroinferior labral tears.
Materials and Methods
In the FADIR position, the arm is placed across the chest, with the hand on the contralateral shoulder and palm facing outwards. FADIR positioning was performed if there was a subtle or equivocal abnormality of the posteroinferior labrum on conventional MR arthrography sequences. A retrospective review of the charts of 9 people who were imaged using FADIR positioning in addition to routine MR arthrographic sequences of the shoulder was performed. The review included the indication for the study, documentation of presence of clinical posterior instability, and surgical correlation, where available.
Results
In all 9 patients, FADIR positioning helped confirm, exclude, or better characterize a posteroinferior labral abnormality by increasing the diagnostic confidence.
Conclusion
Flexion, adduction, and internal rotation positioning appears to be a useful adjunct in evaluating patients with equivocal or subtle posteroinferior labral abnormalities on conventional MR arthrography sequences.
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Acknowledgements
We extend thanks to all MR technologists at St. Joseph’s Healthcare for their help with this study. We would also like to thank Glen Oomen for preparation of the illustrations, Dr. Nick Plaskos for his help.
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Chiavaras, M.M., Harish, S. & Burr, J. MR arthrographic assessment of suspected posteroinferior labral lesions using flexion, adduction, and internal rotation positioning of the arm: preliminary experience. Skeletal Radiol 39, 481–488 (2010). https://doi.org/10.1007/s00256-010-0907-3
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DOI: https://doi.org/10.1007/s00256-010-0907-3