1
|
Simão MN, Kobayashi MJ, Hernandes MDA, Nogueira-Barbosa MH. Evaluation of variations of the glenoid attachment of the inferior glenohumeral ligament by magnetic resonance arthrography. Radiol Bras 2021; 54:148-154. [PMID: 34108761 PMCID: PMC8177672 DOI: 10.1590/0100-3984.2020.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the anatomical variations of the attachment of the inferior glenohumeral ligament (IGHL) to the anterior glenoid rim. Materials and Methods This was a retrospective review of 93 magnetic resonance arthrography examinations of the shoulder. Two radiologists, who were blinded to the patient data and were working independently, read the examinations. Interobserver and intraobserver agreement were evaluated. The pattern of IGHL glenoid attachment and its position on the anterior glenoid rim were recorded. Results In 50 examinations (53.8%), the glenoid attachment was classified as type I (originating from the labrum), whereas it was classified as type II (originating from the glenoid neck) in 43 (46.2%). The IGHL emerged at the 4 o'clock position in 58 cases (62.4%), at the 3 o'clock position in 14 (15.0%), and at the 5 o'clock position in 21 (22.6%). The rates of interobserver and intraobserver agreement were excellent. Conclusion Although type I IGHL glenoid attachment is more common, we found a high prevalence of the type II variation. The IGHL emerged between the 3 o'clock and 5 o'clock positions, most commonly at the 4 o'clock position.
Collapse
Affiliation(s)
- Marcelo Novelino Simão
- Central Diagnóstico de Ribeirão Preto (Cedirp), Ribeirão Preto, SP, Brazil.,Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | | | - Matheus de Andrade Hernandes
- Central Diagnóstico de Ribeirão Preto (Cedirp), Ribeirão Preto, SP, Brazil.,Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | | |
Collapse
|
2
|
Value of Anterior Band of the Inferior Glenohumeral Ligament Area as a Morphological Parameter of Adhesive Capsulitis. Pain Res Manag 2019; 2019:9301970. [PMID: 31205575 PMCID: PMC6530218 DOI: 10.1155/2019/9301970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 11/25/2022]
Abstract
Objective Thickened inferior glenohumeral ligament (IGHL) is considered as one of the major morphological parameters of adhesive capsulitis (AC). Previous studies reported that the anterior band of inferior glenohumeral ligament thickness (aIGHLT) is correlated with shoulder capsular contracture, luxatio erecta humeri, and AC. However, the thickness varies from the measured angle. To reduce this measurement error, we devised a new morphological parameter, called the anterior band of inferior glenohumeral ligament area (aIGHLA). Methods The aIGHL samples were collected from 54 patients with AC and from 50 control subjects who underwent shoulder magnetic resonance imaging (MRI) without any evidence of AC. Coronal T2-weighted MRI images were obtained at the shoulder level from each patient. We measured the aIGHLA and aIGHLT at the maximal view of the IGHL in the coronal plane using our picture archiving and communication system. The aIGHLA was measured at the whole cross-sectional area of the IGHL in the most hypertrophied segment of the coronal MR images. The aIGHLT was measured at the thickest point of the IGHL. Results The average aIGHLA was 55.58 ± 14.16 mm2 in the control group and 83.71 ± 28.45 mm2 in the AC group. The average aIGHLT was 3.47 ± 0.99 mm in the control group and 4.52 ± 1.02 mm in the AC group. AC patients showed significantly greater aIGHLA (p < 0.001) and aIGHLT (p < 0.001) than control subjects. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off score of the aIGHLA was 63.37 mm2, with 79.6% sensitivity, 80.0% specificity, and AUC of 0.84 (95% CI, 0.76–0.92). The optimal cut-off point of the IGHLT was 3.81 mm, with 74.1% sensitivity, 74.0% specificity, and AUC of 0.77 (95% CI, 0.68–0.86). Conclusions Although the aIGHLA and aIGHLT were both significantly associated with AC, the aIGHLA was a more sensitive diagnostic parameter.
Collapse
|
3
|
Simonds E, Wilson C, Iwanaga J, Laws T, Holley G, Oskouian RJ, Tubbs RS. A Comprehensive Review of Medical Imaging Equipment Used in Cadaveric Studies. Cureus 2018. [PMID: 29535907 PMCID: PMC5841925 DOI: 10.7759/cureus.2035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Medical imaging techniques have led to great advances in clinical anatomy and forensic pathology. New and emerging technologies allow healthcare professionals to view and understand the human body from different perspectives. This gives way to new and improved interventions, treatment plans, and an overall understanding of the human body. Herein, we present a comprehensive review of the various medical imaging equipment used in cadaveric studies along with their individual strengths and limitations.
Collapse
|
4
|
De Coninck T, Ngai SS, Tafur M, Chung CB. Imaging the Glenoid Labrum and Labral Tears. Radiographics 2017; 36:1628-1647. [PMID: 27726737 DOI: 10.1148/rg.2016160020] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The shoulder joint is the most unstable articulation in the entire human body. While this certainly introduces vulnerability to injury, it also confers the advantage of broad range of motion. There are many elements that work in combination to offset the inherent instability of the glenohumeral joint, but the glenoid labrum is perhaps related most often. Broadly, clinical unidirectional instability can be subdivided into anterior and posterior instability, which usually raise concern for anteroinferior and posteroinferior labral lesions, respectively. In the special case of superior labral damage, potential dislocation is blocked by structures that include the acromion; hence, while damage elsewhere commonly manifests as clinical instability, damage to the superior labrum is often described by the term microinstability. In this particular case, one of the radiologist's main concerns should be classic superior labral anteroposterior lesions. The glenoid labrum is also subject to a wide range of normal variants that can mimic labral tears. Knowledge of these variants is central to interpreting an imaging study of the labrum because misdiagnosis of labral variants as tears can lead to superfluous surgical procedures and decreased shoulder mobility. This article reviews labral anatomy and normal labral variants, describes their imaging features, and discusses how to discriminate normal variants from labral tears. Specific labral pathologic lesions are described per labral quadrant (anteroinferior, posteroinferior, and superior), and imaging features are described in detail. Online supplemental material is available for this article. ©RSNA, 2016.
Collapse
Affiliation(s)
- Tineke De Coninck
- From the Department of Radiology, Ghent University Hospital, Ghent, Belgium (T.D.C.); Department of Radiology, University of California San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103 (S.S.N., C.B.C.); Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (M.T.); and Radiology Service, VA San Diego Healthcare System, San Diego, Calif (C.B.C.)
| | - Steven S Ngai
- From the Department of Radiology, Ghent University Hospital, Ghent, Belgium (T.D.C.); Department of Radiology, University of California San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103 (S.S.N., C.B.C.); Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (M.T.); and Radiology Service, VA San Diego Healthcare System, San Diego, Calif (C.B.C.)
| | - Monica Tafur
- From the Department of Radiology, Ghent University Hospital, Ghent, Belgium (T.D.C.); Department of Radiology, University of California San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103 (S.S.N., C.B.C.); Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (M.T.); and Radiology Service, VA San Diego Healthcare System, San Diego, Calif (C.B.C.)
| | - Christine B Chung
- From the Department of Radiology, Ghent University Hospital, Ghent, Belgium (T.D.C.); Department of Radiology, University of California San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103 (S.S.N., C.B.C.); Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (M.T.); and Radiology Service, VA San Diego Healthcare System, San Diego, Calif (C.B.C.)
| |
Collapse
|
5
|
Abstract
Imaging of the shoulder forms an important adjunct in clinical decision making in patients with shoulder instability. The typical lesions related with classic anterior and anteroinferior shoulder dislocation are an anteroinferior labral avulsion with or without bony fragment of bone loss – a (bony) Bankart lesion – and a posterolateral humeral head impaction fracture – the Hill-Sachs lesions. These are relatively straightforward to identify on imaging, although normal variants of the inferior labrum and variants of labral damage may cause confusion. Other capsuloligamentous lesions, often associated with less typical types of instability, are much more difficult to identify correctly on imaging, as they occur in the anterosuperior part of the glenohumeral joint with its many normal variants or because they result in more subtle, and therefore easily overlooked, changes in morphology or signal intensity. This paper aims at describing the appearance of the normal and pathologic glenohumeral joint related to shoulder instability. Ample reference will be given as to why identification of abnormalities, whether normal or pathologic, is important to the surgeon facing a treatment decision.
Collapse
|
6
|
Abe SI, Aoki M, Nakao T, Kasahara M, Rodriguez-Vazquez JF, Murakami G, Cho BH. Variation of the subscapularis tendon at the fetal glenohumeral joint. Okajimas Folia Anat Jpn 2014; 90:89-95. [PMID: 24815107 DOI: 10.2535/ofaj.90.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We examined the topohistology of the subscapularis tendon at the glenohumeral joint in 10 mid-term (15-16 weeks of gestation) and 10 late-stage (27-32 weeks) human fetuses. At both stages, there were two patterns of terminal course of the subscapularis tendon: 1) the tendon was tightly attached to the medial part of the joint capsule and extended anterosuperiorly along the capsule to the lesser tubercle (7/10 mid-term fetuses; 5/10 late-stage fetuses); 2) the tendon passed superiorly through the joint cavity for a long distance in combination with the subcoracoid bursa opening widely to the joint cavity (3/10 mid-term fetuses; 5/10 late-stage fetuses). The lower glenoid labrum tended to be well developed in the former pattern because the subscapularis tendon did not interfere with the superior extension of the labrum. With only one exception (late stage), the capsule-attaching tendon was seen in fetuses in which the coracoid process was located on the superior side of the lesser tubercle, whereas the intra-articular tendon accompanied the coracoid process at the same supero-inferior level of the tubercle. Thus, the topographical relationship between the coracoid process and lesser tubercle in fetuses seemed to determine the courses of the subscapularis tendon at the glenohumeral joint. The present variation in the subscapularis tendon was likely connected with the adult morphologies of the middle and inferior glenohumeral ligaments or folds, whose variations are well known.
Collapse
|
7
|
Wang M, Shen W, Wang RF. Variant anatomy of the shoulder on MRI. JOURNAL OF HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY. MEDICAL SCIENCES = HUA ZHONG KE JI DA XUE XUE BAO. YI XUE YING DE WEN BAN = HUAZHONG KEJI DAXUE XUEBAO. YIXUE YINGDEWEN BAN 2013; 33:805-809. [PMID: 24337839 DOI: 10.1007/s11596-013-1202-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 11/01/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Min Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Shen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ren-Fa Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|