Cusmano F, Pedrazzini M, Uccelli M, Ferrozzi F, Armaroli S, Adravanti P, Ampollini A, Pavone P
Istituto di Scienze Radiologiche, Università degli Studi di Parma.
Acta Biomed Ateneo Parmense. 2000;71(6):227-35.
Shoulder instability is often diagnosed among athletes; two clinical forms are distinguished: anatomical instability, with recurrent luxation of the shoulder, and functional instability, with pain, articular "click" and sensation of instability. Lesions of periarticular soft tissues (capsula, fibrocartilaginous labrum, gleno-humeral ligaments and rotator cuff) are common in both forms, while lesions of bone structures (humeral head and glenoid of scapula) are typical of shoulder with previous dislocation. Purpose of our retrospective study was to verify the value of magnetic resonance (MRI) and computed arthrography (arthro-CT) in diagnosing these lesions in 57 patients suffering from shoulder instability. On the basis of our results and experience we think that in a preoperative evaluation of an unstable shoulder, arthro-CT and arthro-MRI are more accurate because the intra-articular injection of a contrast medium better identifies lesions of capsula, gleno-humeral ligaments and fibrocartilaginous labrum. In other circumstances, such as the study of the shoulder for legal purposes, MRI is preferable because it offers an accurate and global evaluation of periarticular structures.
肩部不稳定在运动员中常被诊断出来;可区分出两种临床类型:解剖学不稳定,伴有肩部反复脱位;功能性不稳定,伴有疼痛、关节“咔嗒”声和不稳定感。两种类型中关节周围软组织(关节囊、纤维软骨盂唇、盂肱韧带和肩袖)的损伤都很常见,而骨结构(肱骨头和肩胛骨盂)的损伤是既往有脱位史的肩部的典型表现。我们这项回顾性研究的目的是验证磁共振成像(MRI)和计算机关节造影(关节CT)在诊断57例肩部不稳定患者这些损伤中的价值。基于我们的结果和经验,我们认为在对不稳定肩部进行术前评估时,关节CT和关节MRI更准确,因为关节内注射造影剂能更好地识别关节囊、盂肱韧带和纤维软骨盂唇的损伤。在其他情况下,比如出于法律目的对肩部进行检查时,MRI更可取,因为它能对关节周围结构进行准确的全面评估。