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Benes M, Fulin P, Kachlik D, Al-Redouan A, Tomaides J, Kysilko M, Salavova S, Kunc V. Osseous variations associated with physiological thinning of the glenoid articular cartilage: an osteological study with CT, MRI and arthroscopic correlations. Skeletal Radiol 2023; 52:2435-2449. [PMID: 37227484 PMCID: PMC10581943 DOI: 10.1007/s00256-023-04358-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To investigate the relationship between osseous variations of the glenoid fossa and thinning of the overlaying articular cartilage. MATERIALS AND METHODS In total, 360 dry scapulae, comprising adult, children and fetal specimens, were observed for potential presence of osseous variants inside the glenoid fossa. Subsequently, the appearance of the observed variants was evaluated using CT and MRI (each 300 scans), and in-time arthroscopic findings (20 procedures). New terminology of the observed variants was proposed by an expert panel formed by orthopaedic surgeons, anatomists and radiologists. RESULTS Tubercle of Assaky was observed in 140 (46.7%) adult scapulae, and an innominate osseous depression was identified in 27 (9.0%) adult scapulae. Upon radiological imaging, the tubercle of Assaky was found in 128 (42.7%) CTs and 118 (39.3%) MRIs, while the depression was identified in 12 (4.0%) CTs and 14 (4.7%) MRIs. Articular cartilage above the osseous variations appeared relatively thinner and in several young individuals was found completely absent. Moreover, the tubercle of Assaky featured an increasing prevalence with aging, while the osseous depression develops in the second decade. Macroscopic articular cartilage thinning was identified in 11 (55.0%) arthroscopies. Consequently, four new terms were invented to describe the presented findings. CONCLUSION Physiological articular cartilage thinning occurs due to the presence of the intraglenoid tubercle or the glenoid fovea. In teenagers, the cartilage above the glenoid fovea may be naturally absent. Screening for these variations increases the diagnostic accuracy of glenoid defects. In addition, implementing the proposed terminological updates would optimize communication accuracy.
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Affiliation(s)
- Michal Benes
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Fulin
- 1st Department of Orthopaedics, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - David Kachlik
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Health Care Studies, College of Polytechnics, Jihlava, Czech Republic
| | - Azzat Al-Redouan
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Tomaides
- 1st Department of Orthopaedics, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Martin Kysilko
- Department of Radiology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Sarka Salavova
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vojtech Kunc
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic.
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
- Clinic of Trauma Surgery, Masaryk Hospital, Usti Nad Labem, Czech Republic.
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Detection of the glenoid bare spot by non-arthrographic MR imaging, conventional MR arthrography, and 3D high-resolution T1-weighted VIBE MR arthrography: comparison with CT arthrography. Eur Radiol 2023; 33:3276-3285. [PMID: 36792853 DOI: 10.1007/s00330-023-09443-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To determine the diagnostic accuracy of non-arthrographic MR imaging, conventional MR arthrography, and 3D T1-weighted volumetric interpolated breath-hold examination (VIBE) MR arthrography sequences as compared with a CT arthrography in the diagnosis of glenoid bare spot. METHODS A retrospective study of 216 patients who underwent non-arthrographic MR imaging, conventional MR arthrography, VIBE MRI arthrography, and CT arthrogram between January 2011 and March 2022 was conducted. The diagnostic accuracy of non-arthrographic MR imaging, direct MR arthrography, and VIBE MRI arthrography in the detection of glenoid bare spot was compared with that of CT arthrography. All studies were reviewed by 2 MSK radiologists. Interobserver agreement for MR imaging and MR arthrographic findings was calculated. RESULTS Sixteen of 216 patients were excluded. Twenty-three of 200 shoulders had glenoid bare spot on CT arthrographic images. The glenoid bare spot was detected in 11 (47.8%) and 7 (30.4%) patients on conventional non-arthrographic MR images and in 18 (78.3%) and 16 (69.6%) patients on conventional MR arthrograms by observers 1 and 2, respectively. Both observers separately described the bare spot in 22 of 23 patients (95.7%) on 3D volumetric MR arthrograms. Interobserver variabilities were fair agreement for conventional non-arthrographic MR imaging (κ = 0.35, p < 0.05), moderate agreement for conventional MR arthrogram (κ = 0.50, p < 0.05), and near-perfect agreement for 3D volumetric MR arthrogram reading (κ = 0.87, p < 0.05). CONCLUSIONS A 3D high-resolution T1-weighted VIBE MR arthrography sequence may yield diagnostic performance that is comparable with that of CT arthrography in the diagnosis of glenoid bare spot. KEY POINTS •Glenoid bare spot should not be misdiagnosed as a transchondral defect of the glenoid surface by radiologists. •A 3D high-resolution T1-weighted VIBE MR arthrography sequence may be used as a high-sensitivity imaging technique in the diagnosis of glenoid bare spot.
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