Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Evaluation of Inferior Capsular Laxity in Patients with Atraumatic Multidirectional Shoulder Instability with Magnetic Resonance Arthrography

  • Kyoung-Jin Park (Goodsam Orthopaedic Clinic) ;
  • Ho-Seung Jeong (Department of Orthopaedic Surgery, Chungbuk National University Hospital) ;
  • Ji-Kang Park (Department of Orthopaedic Surgery, Chungbuk National University Hospital) ;
  • Jung-Kwon Cha (Department of Orthopaedic Surgery, Chungbuk National University Hospital) ;
  • Sang-Woo Kang (Department of Orthopaedic Surgery, Chungbuk National University Hospital)
  • Received : 2018.08.09
  • Accepted : 2019.02.13
  • Published : 2019.06.01
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Abstract

Objective: To compare inferior capsular redundancy by using magnetic resonance arthrography (MRA) images in patients with multidirectional instability (MDI) of the shoulder and control subjects without instability and thereby develop a screening method to identify the presence of shoulder MDI. Materials and Methods: The MRA images of patients with MDI of the shoulder (n = 65, 57 men, 8 women; mean age, 24.5 years; age range, 18-42 years) treated over an eight-year period were retrospectively reviewed; a control group (n = 65, 57 men, 8 women; mean age, 27.4 years; age range, 18-45 years) without instability was also selected. The inferior capsular redundancy was measured using a new method we named the glenocapsular (GC) ratio method. MRA images of both groups were randomly mixed together, and two orthopedic surgeon reviewers measured the cross-sectional areas (CSAs) and sagittal capsule-head ratios on oblique sagittal images, as well as the axial capsule-head ratios on axial images and GC ratios on oblique coronal images. Results: The CSAs and GC ratios were significantly higher in patients than in controls (both, p < 0.001); however, the sagittal capsule-head ratios and axial capsule-head ratios were not significantly different (p = 0.317, p = 0.053, respectively). In addition, GC ratios determined the presence of MDI more sensitively and specifically than did CSAs. A GC ratio of > 1.42 was found to be most suggestive of MDI of the shoulder, owing to its high sensitivity (92.3%) and specificity (89.2%). Conclusion: GC ratio can be easily measured and used to accurately screen for MDI of the shoulder.

Keywords

Acknowledgement

I extend my appreciation to all colleagues that aided me during this study.

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