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Thursday, October 2, 2014
Shoulder MRI findings
I am a 29 y/o male who had an open bankart repair in 12/2000. Since then I have been predominately pain free, other than a few feelings of instability. 2.5 weeks ago I fell backwards and caught myself on a chain link fence pushing my weight against the same shoulder.
Saw my doc, ordered an arthrogram mri, here are the results:
INDICATION: Pain after injury. History of prior Bankart tear status post repair TECHNIQUE: Fat-saturated T1-weighted imaging was performed in the coronal, axial, and abduction external rotation planes following the intraarticular injection of dilute gadolinium. The injection portion of the study was performed by a different radiologist, and procedure details will be reported separately. In addition, standard T2 and coronal sequences were obtained along with a sagittal non-fat-saturated T1-weighted sequence. FINDINGS: The amount of intraarticular gadolinium is adequate. There is a mild deformity of the anteroinferior labrum and anteroinferior glenoid cortex. The articular cartilage is intact. No communicating defect within the anterior labrum, although there is significant blunting. There is also patulous axillary pouch and anteroinferior joint space with distortion and irregularity of the anterior band of the inferior glenohumeral ligament. The middle glenohumeral ligament is thinned, but otherwise intact. Superior glenohumeral ligament is intact. There is an area of focal attenuation along the posterosuperior labrum inferior to the level of the biceps anchor. The biceps anchor and intraarticular long head biceps tendon is intact, although there is mild increased signal within the substance of the tendon proximally. There is fraying of the posterosuperior labrum without discrete communicating tear or circumferential tear. The posteroinferior labrum appears to be intact. Rotator cuff is intact. There is minimal articular surface irregularity of the infraspinatus tendon posteriorly near its insertion. There is also minimal surface irregularity of the anterior supraspinatus. The subscapularis is intact. There are small foci of susceptibility artifact over the rotator interval and near the anterior glenoid, likely related to prior labral repair. AC joint is within normal limits. Suprascapular and spinoglenoid notches are clear. IMPRESSION: Status post anterior labral repair. There is blunting and surface irregularity of the anteroinferior labrum that could represent labral degeneration or sequelae of prior tear/labral repair. No communicating tear or displaced tear is seen at this time. Comparison to any prior imaging would be helpful to assess for interval change. 2. Abnormal appearance of the anterior band of the inferior glenohumeral ligament with patulous inferior joint space and thinning of the middle glenohumeral ligament. This could be related to chronic capsular laxity and prior glenohumeral ligament injury. Partial tear or ligamentous strain cannot be excluded given the clinical history. No full-thickness glenohumeral ligament tear is identified. 3. Mild fraying of the posterosuperior labrum compatible with a type I SLAP lesion. No extension into the biceps anchor or posteroinferior labrum. 4. Mild rotator cuff tendinopathy with no evidence of full-thickness tear or significant partial-thickness defect. 5. Mild intraarticular biceps tendinosis.
Any reason to suspect significant injury?
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