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KMID : 0880420190200060931
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Korean Journal of Radiology
2019 Volume.20 No. 6 p.931 ~ p.938
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Evaluation of Inferior Capsular Laxity in Patients with Atraumatic Multidirectional Shoulder Instability with Magnetic Resonance Arthrography
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Park Kyoung-Jin
Jeong Ho-Seung
Park Ji-Kang
Cha Jung-Kwon
Kang Sang-Woo
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Abstract
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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.
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KEYWORD
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Multidirectional shoulder instability, MDI, Magnetic resonance arthrography, MRA, Capsular redundancy, Inferior instability
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