Lohiya Nimisha, Hussein Mohsin, Sahu Amit Kumar, Aggarwal Bharat, Maheshwari Jitendra, Iyengar Karthikeyan P, Botchu Rajesh
Department of Radiology, Royal Derby Hospital, Derby, UK.
Department of Musculoskeletal Radiology, The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
Skeletal Radiol. 2025 May;54(5):967-978. doi: 10.1007/s00256-024-04797-y. Epub 2024 Sep 12.
Evaluation of glenoid bone loss following recurrent anterior shoulder dislocations is normally performed using cross sectional imaging.
To assess how anteroposterior (AP) and Bernageau view radiographs compare to computed tomography (CT), magnetic resonance imaging (MRI) and arthroscopy for evaluating glenoid bone loss in patients with recurrent anterior shoulder dislocation.
A prospective observational study was performed on 32 patients over two years at a tertiary orthopedic center. The loss of sclerotic glenoid rim (LSGL) on AP radiograph and the percentage relative glenoid bone loss on the Bernageau radiograph were assessed. The percentage glenoid bone loss and anterior straight line (ASL) were calculated using a best fit en face circle method using CT and MRI. Percentage glenoid bone loss was also calculated during arthroscopy in multiples of 5%.
In our study, 90.6% (29) patients were males, while only 9.4% (3) were females. This can be attributed to the involvement of the males in outdoor activities and sports. Also, the maximum number of patients were found to belong to 21-30 years of age, with the mean age being 28.66 years. Of the 32 patients, loss of sclerotic glenoid line (LSGL) on AP radiographs correlated with glenoid bone loss on cross-sectional imaging in 27 patients. Three patients had equivocal LSGL and 2 patients with glenoid bone loss on CT did not demonstrate LSGL. The difference between the two modalities was not statistically significant (p value = 0.002). The glenoid bone loss on Bernageau view correlated with glenoid bone loss on cross sectional imaging in all but one patient. The bone loss as evaluated by radiograph Bernageau view was found to have strong correlation (correlation coefficient r = 0.948, p value < 0.0001).
AP and Bernageau radiographic views for anterior shoulder dislocations demonstrate good correlation with glenoid bone loss on cross-sectional imaging. They may also be used as an adjunct to predict overall bone loss on CT and at arthroscopy.
复发性肩关节前脱位后肩胛盂骨丢失的评估通常采用横断面成像。
评估前后位（AP）和贝纳热位X线片与计算机断层扫描（CT）、磁共振成像（MRI）及关节镜检查在评估复发性肩关节前脱位患者肩胛盂骨丢失方面的差异。
在一家三级骨科中心，对32例患者进行了为期两年的前瞻性观察研究。评估AP X线片上硬化肩胛盂边缘丢失（LSGL）情况以及贝纳热位X线片上相对肩胛盂骨丢失百分比。使用CT和MRI通过最佳拟合正面圆法计算肩胛盂骨丢失百分比和前直线（ASL）。在关节镜检查时也以5%的倍数计算肩胛盂骨丢失百分比。
在我们的研究中，90.6%（29例）患者为男性，而女性仅占9.4%（3例）。这可能归因于男性参与户外活动和体育运动。此外，发现患者数量最多的年龄段为21 - 30岁，平均年龄为28.66岁。32例患者中，AP X线片上硬化肩胛盂线丢失（LSGL）与横断面成像上的肩胛盂骨丢失在27例患者中具有相关性。3例患者的LSGL情况不明确，2例CT显示有肩胛盂骨丢失的患者未显示LSGL。两种检查方式之间的差异无统计学意义（p值 = 0.002）。除1例患者外，贝纳热位上的肩胛盂骨丢失与横断面成像上的肩胛盂骨丢失具有相关性。通过贝纳热位X线片评估的骨丢失具有很强的相关性（相关系数r = 0.948，p值 < 0.0001）。
肩关节前脱位的AP和贝纳热位X线片与横断面成像上的肩胛盂骨丢失具有良好的相关性。它们也可作为预测CT及关节镜检查时总体骨丢失的辅助手段。
