Sublabral clefts and recesses in the anterior, inferior, and posterior glenoid labrum at MR arthrography

Department of Radiology, University of Wisconsin School of Medicine and Public Health, Box 3252, 600 Highland Avenue, Madison, WI, 53792-3252, USA, .
Skeletal Radiology (Impact Factor: 1.51). 08/2012; 42(3). DOI: 10.1007/s00256-012-1496-0
Source: PubMed


To determine the prevalence of a normal variant cleft/recess at the labral–chondral junction in the anterior, inferior, and posterior portions of the shoulder joint.
Materials and methods
One hundred and three consecutive patients (106 shoulders) who had a direct MR arthrogram followed by arthroscopic surgery were enrolled in this IRB-approved study. Scans were carried out on a 1.5-T scanner with an eight-channel shoulder coil. The glenoid rim was divided into eight segments and the labrum in all but the superior and anterosuperior segments was evaluated by two radiologists for the presence of contrast between the labrum and articular cartilage. We measured the depth of any cleft/recess and correlated the MR findings with surgical results. Generalized estimating equation models were used to correlate patient age and gender with the presence and depth of a cleft/recess, and Cohen’s kappa values were calculated for interobserver variability.
For segments that were normal at surgery, a cleft/recess was present within a segment on MR arthrogram images in as few as 7 % of patients (within the posteroinferior segment by observer 1), and in up to 61 % of patients (within the posterosuperior segment by observer 1). 55–83 % of these were only 1 mm deep. A 2- to 3-mm recess was seen within 0–37 % of the labral segments, most commonly in the anterior, anteroinferior, and posterosuperior segments. Age and gender did not correlate with the presence of a cleft/recess, although there was an association between males and a 2- to 3-mm deep recess (p = 0.03). The interobserver variability for each segment ranged between 0.15 and 0.49, indicating slight to moderate agreement.
One-mm labral–chondral clefts are not uncommon throughout the labrum. A 2- to 3-mm deep smooth, medially curved recess in the anterior, anteroinferior or posterosuperior labrum can rarely be seen, typically as a continuation of a superior recess or anterosuperior labral variant.

124 Reads
  • Source
    • "greater than 1 mm in the older group, suggesting these to be age-related changes. However, a recent study with patients undergoing arthroscopy indicated an incidence of 40% for 1 mm recesses, and that age and gender were not correlated with these changes (Tuite et al 2013). Rao et al (2003) characterised the anatomical variants in the anterosuperior aspect of the glenoid labrum in a group of patients undergoing arthroscopic surgery, with the average age of 45 years. "
    [Show abstract] [Hide abstract]
    ABSTRACT: An increased incidence of glenoid labral injuries has been reported, possibly due to advances in imaging procedures with an improved ability to define these injuries. This narrative review describes the common variations of the glenoid labrum, age-related changes and effects of sport- and occupation-related stress. Five electronic databases were searched using the following keywords: shoulder joint, glenoid labrum, age factors and age. Thirteen articles met the inclusion criteria: seven investigated cadavers, two throwing sportspeople and four patients undergoing shoulder arthroscopy. Normal anatomical variants include the sublabral foramen and recess, a mobile superior glenoid labrum, a cord-like middle glenohumeral ligament and the Buford complex. These changes start to appear around the age of 30 years with increasing incidence with age, while in throwing sportspeople changes and SLAP lesions commonly appear as early as adolescence. Longitudinal studies are needed to confirm the development of these changes, and whether or not they are associated with risk for future symptoms. However, based on current findings, the presence of the age- or activity-related changes is not always associated with symptoms. Thus, caution is needed when making decisions with regards to the labral changes as possible sources of a patient’s shoulder symptoms.
    Full-text · Article · Jul 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This article reviews the current status of the imaging of the glenoid labrum and associated structures, including anatomic variants and the different types of labral disease.
    Full-text · Article · Jul 2013 · Clinics in sports medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Shoulder MR imaging and MR arthrography are frequently used to evaluate shoulder pain and instability and to assess different types of shoulder injuries. We review different normal variants that can mimic pathologic conditions and some pitfalls that may be encountered in image interpretation. A proper knowledge of normal anatomy is necessary to prevent or minimize errors in diagnosing shoulder injuries.
    No preview · Article · Feb 2014 · Seminars in Musculoskeletal Radiology
Show more