Injuries of the superior portion of the glenoid labrum involving the insertion of the biceps tendon: MR imaging findings in nine cases.

The goal of this investigation was to describe the MR appearance of traumatic fraying or detachment of the superior portion of the glenoid labrum including the insertion of the tendon of the long head of the biceps. This condition is caused either by an acute injury or by repeated overhead motion during participation in sports. In nine patients with such a lesion, the arthroscopic report and MR images were available for review. These patients were 22-64 years old (mean, 38). In four patients only fraying was noted during arthroscopy, in four patients the superior part of the labrum was detached together with the insertion of the biceps tendon, and in one case there was a bucket-handle tear of the superior portion of the labrum. The MR images were retrospectively evaluated by three osteoradiologists in conference. Signal changes within the labrum and detachment of the labrum were noted, and the findings were compared with the results of arthroscopy. MR imaging did not allow recognition of simple fraying. In two of the five cases with arthroscopic findings of detachment of the superior labrum from the glenoid rim, differentiation between complete and partial labral detachments was not possible even with MR arthrography. However, in these cases the patient's age and history led to the correct diagnosis. We conclude that early traumatic abnormalities of the superior portion of the labrum cannot be detected with MR imaging. Complete detachment, however, can be demonstrated if the patient's age and history are taken into consideration.