AbstractObjective: The study's primary objective is to compare the diagnostic efficacy of magnetic resonance (MR) arthrography, arthroscopy, and MDCT arthrography in the preoperative planning of anterior shoulder instability in a larger cohort of 100 patients.
Topics and Techniques: A total of 100 individuals (60 men and 40 women, with a mean age of 29) underwent shoulder MDCT arthrography and MR arthrography over the course of 11 months, beginning in January 2021. The imaging data were examined by two musculoskeletal radiologists who were unaware of the arthroscopic findings. We looked at the sensitivity, specificity, and agreement of arthroscopy for osseous, cartilaginous, and labroligamentous injuries.
Results: MDCT arthrography was more accurate than MR arthrography (= 0.92) in detecting glenoid rim fractures and had a higher sensitivity (100%) and specificity (95%). When comparing MDCT arthrography with MR arthrography for the visualization of glenoid cartilage defects, MDCT arthrography showed a sensitivity of 85%, a specificity of 92%, and a slightly higher agreement with surgery (κ = 0.68) than MR arthrography (κ = 0.62). MDCT arthrography was more accurate than MR arthrography (κ = 0.72) in detecting anterior labral periosteal sleeve avulsion lesions, with a sensitivity of 91% and a specificity of 100%. When comparing MDCT arthrography with MR arthrography for the diagnosis of humeral avulsion of the inferior glenohumeral ligament lesions, the former showed a sensitivity and specificity of 100% (8/8) and a greater agreement with surgery (κ = 0.95).”
Conclusion: When comparing the two imaging modalities for anterior shoulder instability, MDCT arthrography was shown to be more accurate in detecting osseous, cartilage, and labroligamentous lesions in a larger patient cohort than MR arthrography. “MDCT arthrography is a crucial tool for preoperative planning because it accurately detects glenoid rim fractures and humeral avulsion of the inferior glenohumeral ligament abnormalities.” This technique has the potential to significantly impact treatment decisions by facilitating the selection of appropriate surgical interventions.
