Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint.

OBJECTIVE: To describe the posterior labral lesions and labrocapsular abnormalities of the shoulder on sonoarthrography and to compare these findings with MR arthrography results. METHODS: 82 shoulders were initially evaluated with ultrasonography and MRI and then were examined with sonoarthrography and MR arthrography following intraarticular injection of diluted gadolinium solution. The ultrasonography images were prospectively evaluated for the presence of posterior labral tear, sublabral cleft, and posterior capsular abnormalities by two radiologists. The diagnostic accuracy of sonoarthrography in the detection of posterior labral tears and posterior labrocapsular variants was compared with that of MR arthrography. RESULTS: In sonoarthrographic examinations of 82 shoulders, 5 and 6 posterior labral tears were identified by Observer 1 and 2, respectively. Moreover, 6 and 7 posterior sublabral clefts, and 2 and 3 posterior synovial folds were identified by Observer 1 and 2, respectively. All the 82 patients were examined with MR arthrography; however, only 14 patients underwent arthroscopic examination. No significant difference was found among the 82 patients with regard to age, gender, and the prevalence of posterior labral tear, posterior labral cleft, and posterior synovial fold (p > 0.05). Interobserver variability showed substantial agreement between the sonoarthrographic and MR arthrographic results of the posterior labrocapsular structures (κ = 0.71, p < 0.05). CONCLUSION: Posterior labral tears and posterior synovial folds of the shoulder joint can be evaluated non-invasively by sonoarthrography. ADVANCES IN KNOWLEDGE: Variations and pathologies of posterior labrocapsular structures of the glenohumeral joint are relatively uncommon.Direct (MR) arthrography is the gold-standard imaging modality to evaluate of posterior labrocapsular abnormalities of the glenohumeral joint.Sonoarthrography of the glenohumeral joint may be utilized in clinical practice in patients with contraindications to (MRI).

3D volumetric MR arthrographic assessment of shoulder joint capacity in patients with primary adhesive capsulitis.

OBJECTIVE: To evaluate the three-dimensional (3D) volumetric MR arthrographic findings of shoulder joint capacity in patients with primary adhesive capsulitis. METHODS: Thin-section 3D volumetric MR arthrography sequences of the shoulder joint were obtained in 28 patients with clinically and radiologically proven primary adhesive capsulitis and in 25 controls. Volumetric measurements of the total glenohumeral joint capacity, extra-articular contrast material leakage, and the rotator interval, axillary recess, and biceps tendon sheath capacities were performed for the study and control groups. RESULTS: Mean volume of the rotator interval was 7.67 ± 2.6 cm3 in the study group, which was significantly lower than in the control group (12.31 ± 2.5 cm3) (p < 0.0001). Mean volume of the bicipital groove was significantly decreased in the patient group compared to the control group (1.67 ± 0.9 cm3 vs 2.88 ± 0.9 cm3) (p ≤ 0.0001). Mean volume of extra articular contrast material extravasation was 9.93 ± 1.7 cm3 in the patient group, which was significantly higher than in the control group (5.1 ± 1.4 cm3) (p = 0.002). Mean total glenohumeral joint volume was 22.52 ± 1.1 cm3 in the patient group and 26.01 ± 1.2 cm3 in the control group (p = 0.003). CONCLUSION: On 3D volumetric MR arthrographic examination, obliterations in the biceps tendon sheath and rotator interval as well as decreased joint capacity may be useful imaging criteria for diagnosing primary adhesive capsulitis. ADVANCES IN KNOWLEDGE: In the present study, MR arthrography showed contrast material extravasation in 71% of the patients and showed extra articular contrast material extravasation in 48% of the control subjects. On 3D volumetric MR arthrographic examination, obliterations in the biceps tendon sheath and rotator interval as well as decreased joint capacity may be useful imaging criteria for diagnosing primary adhesive capsulitis.In patients with primary adhesive capsulitis, thin-section 3D volumetric MR arthrography is a useful imaging modality to evaluate both joint capacity and capsular structure.