• Title/Summary/Keyword: Shoulder MRI

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Magnetic resonance imaging analysis of rotator cuff tear after shoulder dislocation in a patient older than 40 years

  • Kim, Jung-Han;Park, Jin-Woo;Heo, Si-Young;Noh, Young-Min
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.144-151
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    • 2020
  • Background: This study was designed to evaluate characters of the rotator cuff tear (RCT) recognized after primary shoulder dislocation in patients older than 40. Methods: From 2008 to 2019, patients who visited two hospitals after dislocation were retrospectively reviewed. Inclusion criteria were patients over 40 who had dislocation, with magnetic resonance imaging (MRI) undergone. Exclusion criteria were patients who lost to follow-up, combined with any proximal humerus fracture, brachial plexus injury, and previous operation or dislocation history in the ipsilateral shoulder. Also patients who had only bankart or bony bakart lesion in MRI were excluded. We evaluated RCTs that were recognized by MRI after the primary shoulder dislocation with regard to tear size, degree, involved tendons, fatty degeneration, the age when the first dislocation occurred, and the duration until the MRI was evaluated after the dislocation. Results: Fifty-five RCTs were included. According to age groups, the tear size was increased in coronal and sagittal direction, the number of involved tendons was increased, and the degree of fatty degeneration was advanced in infraspinatus muscle. Thirty-two cases (58.2%) conducted MRI after 3 weeks from the first shoulder dislocation event. This group showed that the retraction size of the coronal plane was increased significantly and the fatty accumulation of the supraspinatus muscle had progressed significantly. Conclusions: Age is also a strong factor to affect the feature of RCT after the shoulder dislocation in patients over 40. And the delay of the MRI may deteriorate the degree of tear size and fatty degeneration.

The Difference in Diagnostic Performance for Detection of Supraspinatus Tendon Tears by Adding Angled Oblique Sagittal Plane Image to the Routine Shoulder MRI (고식적 견관절 자기공명영상에 추가적인 사각시상면 영상 이용 시 극상건 손상 검출 진단능 차이에 대한 고찰)

  • Kim, Ji Hee;Kim, Hyun Joo;Cha, Jang Gyu;Choi, Duk Lin;Hong, Seong Sook;Chang, Yun Woo;Hwang, Jung Hwa
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.157-166
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    • 2014
  • Purpose : The purpose of this study is to determine whether adding an angled oblique sagittal plane to the routine shoulder MRI improves the diagnostic performance in the evaluation of supraspinatus tendon tears with arthroscopic correlation. Materials and Methods: The study included 121 patients who had a shoulder MRI followed by arthroscopy. Two radiologists separately evaluated the supraspinatus tendon for tears on shoulder MRI either with or without the angled oblique sagittal images. Arthroscopy was used as the reference standard. The sensitivity and specificity for diagnosing supraspinatus tendon tears were calculated and compared by using McNemar test. Interobserver and intertechnique variability in the interpretation of supraspinatus tendon tears were calculated as a kappa value. Results: Adding the angled oblique sagittal images to the standard shoulder MRI showed improvement in the sensitivity for diagnosing full-thickness supraspinatus tendon tears and also in the sensitivity, specificity and accuracy for the detection of partial-thickness tears. However, there was no statistically significant difference in all of them between with and without the angled set. Interobserver agreement was substantial to almost perfect and intertechnique agreement was moderate. Conclusion: Adding an angled oblique sagittal plane image to the routine shoulder MRI showed no significantly different diagnostic performance in detecting the partial- and full-thickness supraspinatus tendon tears, compared to MRI without angled oblique sagittal plane.

Multidetector CT (MDCT) Arthrography in the Evaluation of Shoulder Pathology: Comparison with MR Arthrography and MR Imaging with Arthroscopic Correlation (Multidetector CT arthrography를 이용한 견관절 병변의 진단 - MRI, MR arthrography와의 비교 -)

  • Kim, Jae-Yoon;Gong, Hyun-Sik;Kim, Woo-Sung;Choi, Jung-Ah;Kim, Byung-Ho;Oh, Joo-Han
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.73-82
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    • 2006
  • Purpose: The purpose of the present study was to evaluate the diagnostic efficacy of CT arthrography (CTA) in the assessment of various shoulder pathologies, compared with MR arthrography (MRA) and MRI with arthroscopic correlation. Materials and Methods: CTA in 84 patients, MRA in 70 patients, and MRI in 27 patients were obtained. A radiologist interpreted each image for 5 pathologies: Bankart, SLAP, Hill-Sachs lesion, full-thickness, and partial-thickness rotator cuff tear. Detailed arthroscopic reports were compared with CTA, MRA, and MRI. The sensitivity, specificity, predictive values, and accuracy were calculated. The agreement between each diagnostic modality and arthroscopy was calculated. Diagnostic efficacy was assessed by the areas under the receiver operating characteristic (ROC) curves. Results: The diagnostic values of all three imaging groups were comparable to each other for Bankart, SLAP, Hills-Sachs, and full-thickness cuff tear lesions, but those of CTA were lower than MRI and MRA for partial-thickness cuff tears. The areas under the ROC curves for CTA, MRA, and MRI were not significantly different for all pathologies, except for partial-thickness cuff tears. Conclusion: CTA was equally competent to MRA or MRI in demonstrating Bankart, Hill-Sachs lesions, SLAP, and full thickness rotator cuff tears but not as efficient in diagnosing partial thickness rotator cuff tears.

Case Report of Acute Traumatic Rotator Cuff Tear Treatment in Traditional Korean Medicine (외상성 급성 회전근개 파열 환자의 한방치료 1례)

  • Lee, Jeong-Hwan;Ko, Min-Kyung;Yoon, Kwang-Shik;Lee, Chang-Woo;Kim, Young-Il;Kim, Jung-Ho
    • Journal of Pharmacopuncture
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    • v.14 no.4
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    • pp.53-58
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    • 2011
  • Objectives: There is no report on treatment of acute traumatic rotator cuff tear in Traditional Korean Medicine. We reported Traditional Korean Treatment for pain relief and better movement of acute traumatic rotator cuff tear. Methods: Shoulder MRI was used to confirm the diagnosis of tear of rotator cuff. The patient was treated with Traditional Korean Methods (Acupuncture, Herbal medicine, Pharmacopuncture) for 6 months. We evaluated the patient through VAS (Visual Analogue Scale), UCLA shoulder scale, ROM (Range of motion) and Shoulder MRI. Results: After 6 months of treatment, the patient's VAS was decreased whereas UCLA score and Shoulder ROM were increased. Rotator cuff tear was repaired on Shoulder MRI images. Conclusions: In acute traumatic rotator cuff tear, Korean Traditional Treatment is good method for pain relief and better movement.

Evaluation of Effectiveness of Anatomical Rotation Change Image by Aid Tool in Shoulder MRArthrography (Shoulder MRArthography 검사 시 보조기구를 이용한 해부학적 회전 변화 영상에 대한 유용성 평가)

  • Kim, Hyeong-Gyun;Jung, Jae-Eun;Jung, Hong-Moon
    • Journal of the Korean Society of Radiology
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    • v.6 no.4
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    • pp.299-303
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    • 2012
  • Shoulder MRArthrography was performed to get an accurate diagnosis about complex anatomical structure in shoulder joint. We carried out how the changes of anatomical rotations in shoulder joint could bring certain diagnosis effects on MRI images for various shoulder humerus positions; Neutral position, Internal rotation position and External rotation position. In addition, we prepared an aid tool in oder to maintain the right posture of a patient. This aid tool was made by adapting Modeling Design Program. By virtue of this aid, we obtained the following result. Shoulder MR Arthrography by the External rotation position for anatomical structure diagnosis was the most suitable in diagnostic evaluations of important anatomical structures in shoulder joint such as Biceps tendon, Supera-spiatus tendon, Sub-scapularis tendon, Labrum and Sub-acromial space.

Isolated calcific tendinitis at the posterosuperior labrum: a rare case study

  • Suh, Dong-Hwan;Ji, Jong-Hun;Kim, Chang-Yeon
    • Clinics in Shoulder and Elbow
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    • v.23 no.4
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    • pp.194-197
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    • 2020
  • Calcific tendinitis of the shoulder joint, also known as chemical furuncle of the shoulder, causes intense shoulder pain and usually occurs within 1-2 cm from the insertion of the rotator cuff. We experienced a rare case of calcific tendinitis in the posterosuperior labrum of the shoulder joint in a 39-year-old male patient who presented with severe pain and weakness in the right shoulder. Radiographs and magnetic resonance imaging (MRI) findings showed calcific tendinitis in the posterosuperior labrum of the shoulder joint. A 1-week attempt at conservative treatment failed, so the calcified deposit in the posterosuperior labrum was arthroscopically removed. The patient's symptoms were completely relieved, and satisfactory clinical outcomes were achieved. Postoperative follow-up X-ray and MRI showed no recurrence of calcific tendinitis.

MRI of Acute Septic Arthritis of the Shoulder Joint; Correlation with Arthroscopic Findings (급성 화농성 견관절염의 자기공명영상; 관절경적 소견과의 비교 연구)

  • Seo Kyung-Jin;Cheon Sang-Ho;Seo Jae-Sung;Ko Sang-Hun;Choi Chang-Hyuk;Jeon In-Ho
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.110-116
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    • 2005
  • Purpose: Urgent diagnosis and treatment of the septic arthritis is required. The purpose of this study is to review to correlate preoperative MRI findings with arthroscopic findings in septic arthritis of the glenohumeral joint. Materials and Methods: Eleven patients with acute septic arthritis of the glenohumeral joint were treated with combination of arthroscopic lavage, debridement, and systemic antibiotics. The arthroscopic staging of infection was made based on the modified criteria of $G\"{a}chter$ and five major findings of MRI were marked in each stage of septic shoulder. Results: Bone and cartilage erosion was the end stage finding and two patients with all five positive findings had failed with arthroscopic treatment. Reactive bone marrow edema was evident in the greater tuberosity. Joint effusion, synovial thickening and soft tissue edema were rather non-specific finding and presented in all stages of septic shoulder. Conclusion: Diffuse marrow edema with metaphyseal cyst formation in the preoperative MRI implied advanced stage of septic arthritis, which may fail with arthroscopic debridement.