• Davide Volpi, Lucio Olivetti, Piero Budassi, and Eugenio Genovese.
• UO di Radiologia, Presidio Ospedaliero Cremonese, Istituti Ospedalieri di Cremona, Cremona, Italy.
• Radiol Med. 2003 Mar 1;105(3):162-70.

PurposeThe aim of the study was to analyse the accuracy of MR arthrography in the evaluation of capsulo-labro-ligamentous lesions of the shoulder in patients with glenohumeral joint instability.Materials And MethodsFrom 1999 to 2001 fifty-eight patients with glenohumeral joint instability were studied by MR arthrography. Twenty-seven patients underwent surgical repair: 11 by arthroscopic and 16 by arthrotomic approach. All shoulder evaluations were performed with T1 and T2 weighted axial, coronal and sagittal oblique images, before and after intra-articular injection of gadolinium contrast.ResultsForty capsulo-ligamentous lesions (including 14 capsular ruptures with extravasation of the contrast medium) were detected by MR arthrography. Fifty-two labral tears (36 of the anterior, 13 of the superior and 3 of the posterior glenoid labrum) were identified: 11 out of 52 were not recognized before gadolinium contrast injection. Five rotator cuff tears were identified, one of which was not shown in the pre-injection examination. Surgical results confirmed the MR arthrographic findings in 25/27 patients. In one case MR arthrography did not recognize a SLAP lesion; in another case it identified a tear of the capsule but not of the glenoid labrum.ConclusionsIn many cases of subacute glenohumeral joint lesions with intracapsular fluid, MR may accurately evaluate capsulo-labral-ligamentous lesions. Indeed, the examination of lesions is limited by the absence of the natural contrast determined by fluid; in such cases, intra-articular injection of gadolinium contrast is necessary. MR arthrography evaluates the degree of capsulo-labro-ligamentous tears and may guide the surgical approach.

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