Jana Manisha, Gamanagatti Shivanand
Manisha Jana, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, 110029 New Delhi, India.
World J Radiol. 2011 Sep 28;3(9):224-32. doi: 10.4329/wjr.v3.i9.224.
The glenohumeral joint is the most commonly dislocated joint of the body and anterior instability is the most common type of shoulder instability. Magnetic resonance (MR) imaging, and more recently, MR arthrography, have become the essential investigation modalities of glenohumeral instability, especially for pre-procedure evaluation before arthroscopic surgery. Injuries associated with glenohumeral instability are variable, and can involve the bones, the labor-ligamentous components, or the rotator cuff. Anterior instability is associated with injuries of the anterior labrum and the anterior band of the inferior glenohumeral ligament, in the form of Bankart lesion and its variants; whereas posterior instability is associated with reverse Bankart and reverse Hill-Sachs lesion. Multidirectional instability often has no labral pathology on imaging but shows specific osseous changes such as increased chondrolabral retroversion. This article reviews the relevant anatomy in brief, the MR imaging technique and the arthrographic technique, and describes the MR findings in each type of instability as well as common imaging pitfalls.
盂肱关节是人体最常发生脱位的关节,前方不稳是肩部不稳最常见的类型。磁共振(MR)成像,以及最近的MR关节造影,已成为盂肱关节不稳的重要检查方式,尤其是在关节镜手术前的术前评估中。与盂肱关节不稳相关的损伤多种多样,可累及骨骼、关节唇韧带结构或肩袖。前方不稳与前方关节唇和下盂肱韧带前束损伤有关,表现为Bankart损伤及其变异型;而后方不稳与反Bankart损伤和反Hill-Sachs损伤有关。多方向不稳在影像学上通常没有关节唇病变,但显示出特定的骨质改变,如软骨关节唇后倾增加。本文简要回顾相关解剖结构、MR成像技术和关节造影技术,并描述每种不稳类型的MR表现以及常见的影像陷阱。