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Current Reviews in Musculoskeletal Medicine
Published in: Current Reviews in Musculoskeletal Medicine 4/2017

01-12-2017 | Management of Anterior Shoulder Instability (X Li, section editor)

Radiographic Evaluation of Patients with Anterior Shoulder Instability

Authors: Andrew J. Kompel, Xinning Li, Ali Guermazi, Akira M. Murakami

Published in: Current Reviews in Musculoskeletal Medicine | Issue 4/2017

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Abstract

Purpose of Review

Injuries to the labrum, joint capsule (in particular the inferior glenohumeral ligament), cartilage, and glenoid periosteum are associated with anterior shoulder instability. The goal of this review is to provide common radiographic images and findings in patients with anterior shoulder instability. Furthermore, we will demonstrate the best methods for measuring anterior glenoid bone loss.

Recent Findings

Magnetic resonance (MR) imaging is highly relied upon for evaluating anterior shoulder instability and can diagnose soft tissue injuries with high sensitivity. While 3D computed tomography (CT) scan has been considered the optimal tool for evaluating osseous defects, certain MR imaging sequences have been shown to have similar diagnostic accuracy. Repair of Bankart lesions is critical to stabilizing the shoulder, and in the recent years, there has been an increasing focus on imaging to accurately characterize and measure glenoid bone loss to properly indicate patients for either arthroscopic repair or anterior bony reconstruction. Furthermore, Hill-Sachs lesions are commonly seen with shoulder instability, and importance must be placed on measuring the size and depth of these lesions along with possible engagement, as these factors will dictate management.

Summary

The labral-ligamentous complex and rotator cuff are primary stabilizers of the shoulder. With anterior shoulder instability, the labrum is frequently injured. MRI with an arthrogram or provocative maneuvers is the gold standard for diagnosis. Various imaging modalities and methods can be performed to identify and measure Bankart and Hill-Sachs lesions, which can then be used for surgical planning and treating shoulder instability.
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Metadata
Title
Radiographic Evaluation of Patients with Anterior Shoulder Instability
Authors
Andrew J. Kompel
Xinning Li
Ali Guermazi
Akira M. Murakami
Publication date
01-12-2017
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 4/2017
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-017-9433-4

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