DIAGNOSTICS OF SUPERIOR LABRUM ANTERIOR-POSTERIOR TEARS OF THE SHOULDER JOINT: AN ACCURACY AND VALIDITY STUDY USING NON-CONTRAST MR

Abbas Fouad Duaas, Kassim Amir Hadi Taj Al-Dean

 

College of Medicine, University of Babylon. Babylon, Iraq.

 

Superior labral anterior to posterior (SLAP) tears are a clinical subset of conditions associated with complex shoulder discomfort. MRI is a commonly used technique to distinguish SLAP tears.

Purpose. To assess the diagnostic validity of MRI in detecting shoulder ligament tears in a group of patients from Babylon City, Iraq.

Materials and methods. This prospective study included 32 cases of shoulder MRI between July 26, 2023, and May 29, 2024. Collected data included patient age, sex, occupation, dominant arm, affected arm, history of injury or trauma, trauma to the opposite side, history of frozen shoulder, comorbidities, history of sports activities, and overhead motion. Structural MRI findings were studied. MRI was performed using a 1.5-Tesla scanner (Achieva 1.5.0T TX; Netherlands). All images were analyzed by two consultant radiologists.

Results. The study enrolled 32 patients with shoulder complaints, with a mean age of 54.25 ± 13.97 years. Males were more frequent than females (71.9% vs. 28.1%). Right-dominant arms were more common than left (62.5% vs. 37.5%), and right arms were more affected than left (78.1% vs. 21.9%). Four patients (12.5%) reported a history of frozen shoulder. Labral tears were the most common finding, observed in 43.8% of patients, while full-thickness cuff tears were found in 13 patients (40.6%), the second most frequent finding. Nine patients (28.1%) had AC joint degeneration, and biceps tendon involvement was seen in 12 patients (37.5%). MRI demonstrated high sensitivity, specificity, and accuracy in detecting superior labral tears (93.33%, 94.74%, 94.12%), inferior labral tears (95.71%, 96.3%, 95%), and full-thickness cuff tears (92.86%, 95%, 94.22%), with statistically significant differences (p = 0.04, 0.004, and 0.025, respectively).

Discussion. In this study, the two most common structural MRI findings in shoulder joint lesions were superior labral tears and full-thickness cuff tears. Labral tears were also reported as follows: anterior (21.9%), inferior (18.8%), and posterior (18.8%). Partial articular cuff tears were observed in 12.5% of cases. One case showed degenerative changes in the humeral head, while 28.1% of patients presented with AC joint degeneration. Osteophyte formation was detected in three patients. Humeral head edema and joint effusion were observed in three cases each. Partial bursal cuff tears were recorded in two patients. Günay and Kavak reported MRI-positive SLAP lesions in 15 (29%) of 52 patients. A large cohort study of 409 patients by Rotem and colleagues found SLAP lesions in 44% of cases, with a higher prevalence in males (47%) compared to females (24.1%). Labral tears, adhesive capsulitis, rotator cuff injuries, glenohumeral ligament tears, and Hill-Sachs (Bankart) lesions were common structural MRI findings.

Conclusion. Right-dominant arms were more commonly affected by SLAP tears. Labral tears were the most frequent structural MRI finding, with superior labral tears and full-thickness cuff tears reported at high rates. MRI demonstrated high sensitivity and specificity in diagnosing superior and inferior labral tears, as well as full-thickness cuff tears.

 

Keywords: superior labral anterior to posterior, shoulder joint, full-thickness cuff tear, structural MRI, dominant arms.

 

Corresponding author: Abbas Fouad Duaas, e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Abbas Fouad Duaas, Kassim Amir Hadi Taj Al-Dean. Diagnostics of superior labrum anterior-posterior tears of the shoulder joint: an accuracy and validity study using non-contrast MR. REJR 2024; 14(3):79-90. DOI: 10.21569/2222-7415-2024-14-3-79-90.

Received: 16.07.24 Accepted: 11.09.24