Magnetic Resonance Imaging Evaluation of Normal Glenoid Length and Width: An Anatomic Study
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Arthroscopic repair for patients with recurrent instability of the shoulder remains a challenge. Failure after repair has been associated with young patient age, contact or overhead athletic activities, and most significantly, glenoid bone deficiency. Glenoid bone deficiency is usually found in the anteroinferior region and has been observed in 8% to 73% of cases of recurrent shoulder dislocation. Preoperative identification and quantification of glenoid bone loss are critical to determine whether patients require bone reconstruction versus soft-tissue stabilization alone.
The use of computed tomography (CT) scan has been described for preoperative quantification of glenoid bone loss. However, magnetic resonance imaging (MRI) is often initially performed for evaluation of the soft tissues, including the capsuloligamentous structures, labrum, and rotator cuff. The additional use of CT has the potential to lead to increased costs, because it is a second diagnostic test in addition to MRI, and exposure to ra- diation. Thus the ability to accurately quantify glenoid bone loss on MRI would allow the use of a single study to evaluate both bone and soft-tissue pathology.
In 1992 Iannotti published an anatomic study of the normal glenohumeral relations. After they measured 140 cadavers, the superoinferior and lower-half anteroposterior dimensions of the glenoid were found to have some variability, although the ratio of length to width was a relative constant. By use of this information, if the length of the glenoid is preserved, even in bone loss situations, the fixed ratio could be used to calculate the expected width of the glenoid based on the measured length. A comparison of expected width with measured width would provide an estimation of glenoid bone loss.
The purpose of this study was to evaluate the measured dimensions of the normal glenoid on sagittal MRI to determine whether a fixed ratio of glenoid length and width can be determined. Our hypothesis was that glenoid length and width can be consistently measured on sagittal MRI and that a fixed ratio based on these measurements exists.
Full Article: Magnetic Resonance Imaging Evaluation of Normal Glenoid Length and Width: An Anatomic Study
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