Skip to main content
SpringerLink
Log in

Shoulder Instability

  • Chapter
Imaging of Orthopedic Sports Injuries

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 2258 Accesses

9.5 Conclusion

Shoulder instability is an increasing entity among throwing athletes and proper preoperative assessment is sometimes difficult to obtain based on history and physical examination alone. Shoulder MRI with or without contrast enhancement has been proven a very valuable diagnostic modality for the detection of subtle lesions involving the capsule, labrum and ligaments. Recent and changing new concepts on the etiology of some of the instability patterns, especially microinstability, in these patients makes MRI even more valuable to determine if a particular surgical approach may be successful. Further understanding of the early capsular lesions that lead eventually to severe impairment of joint function will be followed undoubtedly by the need for further refinement of the accuracy of the MRI technique and diagnostic skills of the interpreting radiologist.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Beltran J, Bencardino J, Mellado J et al. (1997) MR arthrography of the shoulder: variations and pitfalls. Radiographics 17:1403–1412

    PubMed  CAS  Google Scholar 

  • Bencardino J, Beltran J, Rosenberg ZR et al. (2000) Superior labrum anterior and posterior lesions: MR arthrography of the shoulder. Radiology 214:267–271

    PubMed  CAS  Google Scholar 

  • Budoff JE, Nirschl RP, Ilahi OA et al. (2003) Internal impingement in the etiology of rotator cuff tendinosis revisited. Arthroscopy 19:810–814

    Article  PubMed  Google Scholar 

  • Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology. Part I: Pathoanatomy and biomechanics. Arthroscopy 4:404–420

    Article  Google Scholar 

  • Cartland JP, Crues JP, Stauffer A et al. (1992) MR Imaging in the evaluation of SLAP injuries of the shoulder: findings in 10 patients. AJR 159:787–792

    PubMed  CAS  Google Scholar 

  • Caspari RB, Geissler WB (1993) Arthroscopic manifestations of shoulder subluxation and dislocation. Clin Orthop Rel Res 291:54–66

    Google Scholar 

  • Chandnani VP, Yeager TD, DeBerardino T et al. (1993) Glenoid labral tears: prospective evaluation with MR imaging, MR arthrography, and CT arthrography. AJR 161:1229–1235

    PubMed  CAS  Google Scholar 

  • Chandnani VP, Gagliardi JA, Murnane TG et al. (1995) Glenohumeral ligaments and shoulder capsular mechanism: evaluation with MR arthrography. Radiology 196:27–32

    PubMed  CAS  Google Scholar 

  • Cooper DE, Arnoczky SP, O’Brien SJ et al. (1992) Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study. J Bone Joint Surg Am 74:46–52

    PubMed  CAS  Google Scholar 

  • Garneau RA, Renfrew DL, Moore TE et al. (1991) Evaluation with MR imaging. Radiology 179:519–522

    PubMed  CAS  Google Scholar 

  • Gerber C, Sebesta A (2000) Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report. J Shoulder Elbow Surg 9:483–490

    Article  PubMed  CAS  Google Scholar 

  • Habermeyer P, Magosch P, Pritsch M et al. (2004) Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study. J Shoulder Elbow Surg 13:5–12

    Article  PubMed  Google Scholar 

  • Hodler J, Kursunoglu-Brahme S, Flannigan B, Snyder et al. (1992) Injuries of the superior portion of the glenoid labrum involving the insertion of the biceps tendon: AJR 159:565–568

    PubMed  CAS  Google Scholar 

  • Itoi E, Keuchle DK, Newman SR et al. (1993) Stabilizing function of the biceps in stable and unstable shoulders. J Bone Joint Surg Br 75:546–550

    PubMed  CAS  Google Scholar 

  • Jobe CM (1996) Superior glenoid impingement. Clin Orthop Related Res 330:98–107

    Article  Google Scholar 

  • Jobe FW, Tibone JE, Jobe CM et al. (1990) The shoulder in sports. In: Rockwood CA, Matsen FA (eds) The shoulder. Vol 2. Philadelphia, WB Saunders, pp 961–990

    Google Scholar 

  • Legan JM, Burkhard TK, Goff WB et al. (1991) Tears of the glenoid labrum: MR imaging of 88 arthroscopically confirmed cases. Radiology 179:241–246

    PubMed  CAS  Google Scholar 

  • Mallon WJ, Speer KP (1995) Multidirectional instability: current concepts. J Shoulder Elbow Surg 4:54–64

    Article  PubMed  CAS  Google Scholar 

  • Matsen FA III, Thomas SC, Rockwood CA Jr (1990) Anterior glenohumeral instability. In: Rockwood CA, Matsen FA III (eds) The shoulder. Saunders, Philadelphia, pp 526–622

    Google Scholar 

  • Matsen FA, Harryman DT, Sidles JA (1991) Mechanics of glenohumeral instability. Clin Sports Med 10:783–788

    PubMed  Google Scholar 

  • Meister K (2000) Injuries to the shoulder in the throwing athlete. Part one: biomechanics/pathophysiology/classification. Am J Sports Med 2:265–275

    Google Scholar 

  • Meister K, Andrews JR, Batts J et al. (1999) Symptomatic thrower’s exostosis. Arthroscopic evaluation and treatment. Am J Sports Med 27:133–136

    PubMed  CAS  Google Scholar 

  • Mizuno K, Nabeshima Y, Hirohata K (1993) Analysis of Bankart lesion in the recurrent dislocation or subluxation of the shoulder. Clin Orthop 288:158–165

    PubMed  Google Scholar 

  • Monu JUV, Pope TL, Chabon SJ et al. (1994) MR diagnosis of superior labral anterior poster (SLAP) injuries of the glenoid labrum: value of routine imaging without intrarticular injection of contrast material. AJR 163:1425–1429

    PubMed  CAS  Google Scholar 

  • Moseley HF, Overgaard B (1962) The anterior capsular mechanism in recurrent anterior dislocation of the shoulder. J Bone Joint Surg 44:913–927

    Google Scholar 

  • Neviaser TJ (1993a) The anterior labroligamentous periosteal sleeve avulsion: a cause of anterior instability of the shoulder. Arthroscopy 9:17–21

    Article  PubMed  CAS  Google Scholar 

  • Neviaser TJ (1993b) The GLAD lesion: another cause of anterior shoulder pain. Arthroscopy 9:22–23

    Article  PubMed  CAS  Google Scholar 

  • Novotny JE, Nichols CE, Beynnon BD (1998) Kinematics of the glenohumeral joint with Bankart lesion and repair. J Orthop Res 16(1):116–121

    Article  PubMed  CAS  Google Scholar 

  • O’Brien SJ, Neves MC, Arnoczky SP et al. (1990) The anatomy and histology of the inferior glenohumeral ligament complex of the shoulder. Am J Sports Med 18:449–456

    PubMed  CAS  Google Scholar 

  • O’Connell PW, Nuber GW, Mileski RA et al. (1990) The contribution of the glenohumeral ligaments to anterior stability of the shoulder joint. Am J Sports Med 18:579–584

    PubMed  CAS  Google Scholar 

  • Pagnani MJ, Deng XH, Warren RF et al. (1996) Role of the long head of the biceps brachii in glenohumeral stability: a biomechanical study in cadavera. J Shoulder Elbow Surg 5:255–262

    Article  PubMed  CAS  Google Scholar 

  • Palmer WE, Brown JH, Rosenthal DJ (1994) Labral-ligamentous complex of the shoulder: evaluation with MR arthrography. Radiology 190:654–651

    Google Scholar 

  • Pink M, Jobe FW, Perry J (1990) Electromyographic analysis of the shoulder during the golf swing. Am J Sports Med 8:137–140

    Google Scholar 

  • Rafii M, Firooznia H, Golimbu C et al. (1986) CT arthrography of capsular structures of the shoulder. AJR 146:361–367

    PubMed  CAS  Google Scholar 

  • Schenk TJ, Brems JJ (1998) Multidirectional instability of the shoulder: patho-physiology, diagnosis, and management. J Am Acad Orthop Surg 6(1):65–72

    PubMed  CAS  Google Scholar 

  • Shankman S, Beltran J, Bencardino J (1999) MR Arthrography of the shoulder: glenohumeral instability. Skeletal Radiol 28:365–382

    Article  PubMed  CAS  Google Scholar 

  • Struhl S (2002) Anterior internal impingement: an arthroscopic observation. Arthroscopy 18:2–7

    Article  PubMed  Google Scholar 

  • Tirman PFJ, Feller JF, Palmer WE et al. (1996) The Buford complex. A variation of normal shoulder anatomy: MR arthrographic imaging features. AJR 166:869–873

    PubMed  CAS  Google Scholar 

  • Turkel SJ, Panio MW, Marshall JL et al. (1981) Stabilizing mechanisms preventing anterior dislocations of the glenohumeral joint. J Bone Joint Surg 63:1208–1217

    PubMed  CAS  Google Scholar 

  • Walch G, Boileau P, Noel E et al. (1992) Impingement of the deep surface of the supraspinatus tendon on the posterosuperior glenoid rim: an arthroscopic study. J Shoulder Elbow Surg 1:238–245

    Article  Google Scholar 

  • Warner J, Bowen M, Deng X et al. (1999) Effect of joint compression on inferior stability of the glenohumeral joint. J Shoulder Elbow Surg 8:31–36

    Article  PubMed  CAS  Google Scholar 

  • Weishaupt D, Zanetti M, Tanner A et al. (1999) Lesions of the reflection pulley of the long biceps tendon. MR arthrographic findings. Invest Radiol 34:463–469

    Article  PubMed  CAS  Google Scholar 

  • Williams MM, Snyder SJ, Buford D (1994) The Buford complex-the cordlike MGHL and absent anterosuperior labrum complex: a normal anatomic capsulolabral variant. Arthroscopy 10:241–247

    Article  PubMed  CAS  Google Scholar 

  • Wischer TK, Bredella MA, Genant HK et al. (2002) Perthes lesion (a variant of the Bankart lesion): MR imaging and MR arthrographic findings with surgical correlation. AJR 178:233–237

    PubMed  Google Scholar 

  • Wolf EM, Cheng JC, Dickson K (1995) Humeral avulsion of glenohumeral ligaments as a cause of anterior shoulder instability. Arthroscopy 11(5):600–607

    Article  PubMed  CAS  Google Scholar 

  • Yeh LR, Kwak S, Kim YS et al. (1998) Anterior labroligamentous structures of the glenohumeral joint: correlation of MR arthrography and anatomic dissection in cadavers. AJR 171:1229–1236

    PubMed  CAS  Google Scholar 

  • Zlatkin MB, Bjorkengren AG, Gylys-Morin V et al. (1988) Cross-sectional imaging of the capsular mechanism of the glenohumeral joint. AJR 150:151–158

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, New York, 11219, USA

    Javier Beltran MD, FACR & Agustinus Suhardja MD

Authors
  1. Javier Beltran MD, FACR
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Agustinus Suhardja MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Radiology, University Hospital Antwerp, Wilrijkstraat, 10, 2650, Edegem, Belgium

    Filip M. Vanhoenacker MD, PhD  & Jan L. Gielen MD, PhD  & 

  2. Department of Radiology, Academic Medical Centre, Meibergdreef, 9, Suite C1-210, 1105 AZ, Amsterdam, The Netherlands

    Mario Maas MD, PhD

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Beltran, J., Suhardja, A. (2007). Shoulder Instability. In: Vanhoenacker, F.M., Maas, M., Gielen, J.L. (eds) Imaging of Orthopedic Sports Injuries. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68201-1_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-68201-1_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-26014-1

  • Online ISBN: 978-3-540-68201-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation