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Anatomy, Variants, and Pathologies of the Superior Glenohumeral Ligament: Magnetic Resonance Imaging with Three-Dimensional Volumetric Interpolated Breath-Hold Examination Sequence and Conventional Magnetic Resonance Arthrography

  • Ogul, Hayri (Department of Radiology, Medical Faculty, Ataturk University) ;
  • Karaca, Leyla (Department of Radiology, Medical Faculty, Ataturk University) ;
  • Can, Cahit Emre (Department of Orthopedic, Medical Faculty, Ataturk University) ;
  • Pirimoglu, Berhan (Department of Radiology, Medical Faculty, Ataturk University) ;
  • Tuncer, Kutsi (Department of Orthopedic, Medical Faculty, Ataturk University) ;
  • Topal, Murat (Department of Orthopedic, Medical Faculty, Ataturk University) ;
  • Okur, Aylin (Department of Radiology, Medical Faculty, Ataturk University) ;
  • Kantarci, Mecit (Department of Radiology, Medical Faculty, Ataturk University)
  • Received : 2013.12.13
  • Accepted : 2014.04.13
  • Published : 2014.07.01

Abstract

The purpose of this review was to demonstrate magnetic resonance (MR) arthrography findings of anatomy, variants, and pathologic conditions of the superior glenohumeral ligament (SGHL). This review also demonstrates the applicability of a new MR arthrography sequence in the anterosuperior portion of the glenohumeral joint. The SGHL is a very important anatomical structure in the rotator interval that is responsible for stabilizing the long head of the biceps tendon. Therefore, a torn SGHL can result in pain and instability. Observation of the SGHL is difficult when using conventional MR imaging, because the ligament may be poorly visualized. Shoulder MR arthrography is the most accurately established imaging technique for identifying pathologies of the SGHL and associated structures. The use of three dimensional (3D) volumetric interpolated breath-hold examination (VIBE) sequences produces thinner image slices and enables a higher in-plane resolution than conventional MR arthrography sequences. Therefore, shoulder MR arthrography using 3D VIBE sequences may contribute to evaluating of the smaller intraarticular structures such as the SGHL.

Keywords

References

  1. Bencardino JT, Beltran J. MR imaging of the glenohumeral ligaments. Magn Reson Imaging Clin N Am 2004;12:11-24, v https://doi.org/10.1016/j.mric.2004.01.005
  2. Yang C, Goto A, Sahara W, Yoshikawa H, Sugamoto K. In vivo three-dimensional evaluation of the functional length of glenohumeral ligaments. Clin Biomech (Bristol, Avon) 2010;25:137-141 https://doi.org/10.1016/j.clinbiomech.2009.10.009
  3. Robinson G, Ho Y, Finlay K, Friedman L, Harish S. Normal anatomy and common labral lesions at MR arthrography of the shoulder. Clin Radiol 2006;61:805-821 https://doi.org/10.1016/j.crad.2006.06.002
  4. Cooper DE, O'Brien SJ, Warren RF. Supporting layers of the glenohumeral joint. An anatomic study. Clin Orthop Relat Res 1993;(289):144-155
  5. Pouliart N, Somers K, Eid S, Gagey O. Variations in the superior capsuloligamentous complex and description of a new ligament. J Shoulder Elbow Surg 2007;16:821-836 https://doi.org/10.1016/j.jse.2007.02.138
  6. Ogul H, Bayraktutan U, Yildirim OS, Suma S, Ozgokce M, Okur A, et al. Magnetic Resonance Arthrography of the Glenohumeral Joint: Ultrasonography-Guided Technique Using a Posterior Approach. Eurasian J Med 2012;44:73-78 https://doi.org/10.5152/eajm.2012.18
  7. Zwar RB, Read JW, Noakes JB. Sonographically guided glenohumeral joint injection. AJR Am J Roentgenol 2004;183:48-50 https://doi.org/10.2214/ajr.183.1.1830048
  8. Souza PM, Aguiar RO, Marchiori E, Bardoe SA. Arthrography of the shoulder: a modified ultrasound guided technique of joint injection at the rotator interval. Eur J Radiol 2010;74:e29-e32 https://doi.org/10.1016/j.ejrad.2009.03.020
  9. Yeh L, Kwak S, Kim YS, Pedowitz R, Trudell D, Muhle C, et al. Anterior labroligamentous structures of the glenohumeral joint: correlation of MR arthrography and anatomic dissection in cadavers. AJR Am J Roentgenol 1998;171:1229-1236 https://doi.org/10.2214/ajr.171.5.9798852
  10. Flannigan B, Kursunoglu-Brahme S, Snyder S, Karzel R, Del Pizzo W, Resnick D. MR arthrography of the shoulder: comparison with conventional MR imaging. AJR Am J Roentgenol 1990;155:829-832 https://doi.org/10.2214/ajr.155.4.2119117
  11. Kaplan PA, Bryans KC, Davick JP, Otte M, Stinson WW, Dussault RG. MR imaging of the normal shoulder: variants and pitfalls. Radiology 1992;184:519-524 https://doi.org/10.1148/radiology.184.2.1620858
  12. Chung CB, Dwek JR, Cho GJ, Lektrakul N, Trudell D, Resnick D. Rotator cuff interval: evaluation with MR imaging and MR arthrography of the shoulder in 32 cadavers. J Comput Assist Tomogr 2000;24:738-743 https://doi.org/10.1097/00004728-200009000-00014
  13. Nakata W, Katou S, Fujita A, Nakata M, Lefor AT, Sugimoto H. Biceps pulley: normal anatomy and associated lesions at MR arthrography. Radiographics 2011;31:791-810 https://doi.org/10.1148/rg.313105507
  14. De Maeseneer M, Van Roy F, Lenchik L, Shahabpour M, Jacobson J, Ryu KN, et al. CT and MR arthrography of the normal and pathologic anterosuperior labrum and labralbicipital complex. Radiographics 2000;20 Spec No:S67-S81 https://doi.org/10.1148/radiographics.20.suppl_1.g00oc03s67
  15. De Maeseneer M, Van Roy P, Shahabpour M. Normal MR imaging anatomy of the rotator cuff tendons, glenoid fossa, labrum, and ligaments of the shoulder. Radiol Clin North Am 2006;44:479-487, vii https://doi.org/10.1016/j.rcl.2006.04.002
  16. Dunham KS, Bencardino JT, Rokito AS. Anatomic variants and pitfalls of the labrum, glenoid cartilage, and glenohumeral ligaments. Magn Reson Imaging Clin N Am 2012;20:213-228, x https://doi.org/10.1016/j.mric.2012.01.014
  17. Petchprapa CN, Beltran LS, Jazrawi LM, Kwon YW, Babb JS, Recht MP. The rotator interval: a review of anatomy, function, and normal and abnormal MRI appearance. AJR Am J Roentgenol 2010;195:567-576 https://doi.org/10.2214/AJR.10.4406
  18. Yu D, Turmezei TD, Kerslake RW. FIESTA: an MR arthrography celebration of shoulder joint anatomy, variants, and their mimics. Clin Anat 2013;26:213-227 https://doi.org/10.1002/ca.22066
  19. Shankman S, Bencardino J, Beltran J. Glenohumeral instability: evaluation using MR arthrography of the shoulder. Skeletal Radiol 1999;28:365-382 https://doi.org/10.1007/s002560050533
  20. Kask K, Poldoja E, Lont T, Norit R, Merila M, Busch LC, et al. Anatomy of the superior glenohumeral ligament. J Shoulder Elbow Surg 2010;19:908-916 https://doi.org/10.1016/j.jse.2010.01.019
  21. Chandnani VP, Gagliardi JA, Murnane TG, Bradley YC, DeBerardino TA, Spaeth J, et al. Glenohumeral ligaments and shoulder capsular mechanism: evaluation with MR arthrography. Radiology 1995;196:27-32 https://doi.org/10.1148/radiology.196.1.7784579
  22. Beltran J, Rosenberg ZS, Chandnani VP, Cuomo F, Beltran S, Rokito A. Glenohumeral instability: evaluation with MR arthrography. Radiographics 1997;17:657-673 https://doi.org/10.1148/radiographics.17.3.9153704
  23. Weishaupt D, Zanetti M, Tanner A, Gerber C, Hodler J. Lesions of the reflection pulley of the long biceps tendon. MR arthrographic findings. Invest Radiol 1999;34:463-469 https://doi.org/10.1097/00004424-199907000-00004
  24. Habermeyer P, Magosch P, Pritsch M, Scheibel MT, Lichtenberg S. Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study. J Shoulder Elbow Surg 2004;13:5-12 https://doi.org/10.1016/j.jse.2003.09.013
  25. Braun S, Horan MP, Elser F, Millett PJ. Lesions of the biceps pulley. Am J Sports Med 2011;39:790-795 https://doi.org/10.1177/0363546510393942
  26. Cooper DE, O'Brien SJ, Arnoczky SP, Warren RF. The structure and function of the coracohumeral ligament: an anatomic and microscopic study. J Shoulder Elbow Surg 1993;2:70-77 https://doi.org/10.1016/1058-2746(93)90003-Y
  27. Werner A, Mueller T, Boehm D, Gohlke F. The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. A histoanatomic study. Am J Sports Med 2000;28:28-31 https://doi.org/10.1177/03635465000280011701
  28. Schaeffeler C, Waldt S, Holzapfel K, Kirchhoff C, Jungmann PM, Wolf P, et al. Lesions of the biceps pulley: diagnostic accuracy of MR arthrography of the shoulder and evaluation of previously described and new diagnostic signs. Radiology 2012;264:504-513 https://doi.org/10.1148/radiol.12112007
  29. Gaskill TR, Braun S, Millett PJ. Multimedia article. The rotator interval: pathology and management. Arthroscopy 2011;27:556-567 https://doi.org/10.1016/j.arthro.2010.10.004
  30. Baumann B, Genning K, Bohm D, Rolf O, Gohlke F. Arthroscopic prevalence of pulley lesions in 1007 consecutive patients. J Shoulder Elbow Surg 2008;17:14-20 https://doi.org/10.1016/j.jse.2007.04.011
  31. Walch G, Nove-Josserand L, Levigne C, Renaud E. Tears of the supraspinatus tendon associated with "hidden" lesions of the rotator interval. J Shoulder Elbow Surg 1994;3:353-360 https://doi.org/10.1016/S1058-2746(09)80020-7
  32. Bennett WF. Subscapularis, medial, and lateral head coracohumeral ligament insertion anatomy. Arthroscopic appearance and incidence of "hidden" rotator interval lesions. Arthroscopy 2001;17:173-180 https://doi.org/10.1053/jars.2001.21239
  33. Gerber C, Sebesta A. Impingement of the deep surface of the subscapularis tendon and the reflection pulley on the anterosuperior glenoid rim: a preliminary report. J Shoulder Elbow Surg 2000;9:483-490 https://doi.org/10.1067/mse.2000.109322
  34. Snyder SJ, Karzel RP, Del Pizzo W, Ferkel RD, Friedman MJ. SLAP lesions of the shoulder. Arthroscopy 1990;6:274-279 https://doi.org/10.1016/0749-8063(90)90056-J
  35. Hodler J. Technical errors in MR arthrography. Skeletal Radiol 2008;37:9-18
  36. Guckel C, Nidecker A. The rope ladder: an uncommon artifact and potential pitfall in MR arthrography of the shoulder. AJR Am J Roentgenol 1997;168:947-950 https://doi.org/10.2214/ajr.168.4.9124146

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