Assessment of Capsular Laxity in Patients With Recurrent Anterior Shoulder Dislocation Using MRI
Assessment of Capsular Laxity in Patients With Recurrent Anterior Shoulder Dislocation Using MRI
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DOI：
10.2214/ajr.08.1544
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发表时间：
2009-06-01
影响因子：
5
通讯作者：
Kam, C. K.
中科院分区：
文献类型：
--
作者：
Ng, Alex Wing Hung;Chu, C. M.;Kam, C. K.
OBJECTIVE.本研究的目的是探讨MRI在评估复发性肩关节脱位患者关节囊松弛度中的作用。回顾性分析了2002年10月至2008年5月期间接受MR关节造影术的64例连续患者（研究组包括58例患者，45例男性和13例女性;平均年龄39.3岁;范围13-82岁）的记录。将患者分为三组：A组，无肩关节脱位; B组，首次脱位; C组，复发性脱位。在斜矢状位图像上测量中立位和外展外旋位（ABER）下前、前下和下区的最大囊宽度。评价关节囊宽度与脱位数量、关节囊附着类型、前下盂唇撕裂和患者性别的关系。同时计算MRI和临床试验检测囊袋松弛的敏感性和特异性。在所有三个患者组中，在ABER位置的肩部宽度和前部区域的关节囊收紧程度方面存在显著差异（p < 0.05）。平均最大宽度C组最大，A组最小。B组和C组的前囊紧缩程度有显著性差异。肩关节囊宽度和前囊紧缩度（R = -0.45）与肩关节脱位的数量有中度相关性，与前下盂唇撕裂的存在有关的肩关节囊宽度和前囊紧缩度有显著性差异。临床试验检测囊袋松弛的敏感性和特异性分别为92%和100%，MRI为85%和96%。MRI是评估复发性肩关节脱位患者关节囊松弛的一种有用和客观的方法。
OBJECTIVE. The purpose of our study was to investigate the usefulness of MRI in assessing capsular laxity in patients with recurrent shoulder dislocation.MATERIALS AND METHODS. The records of 64 consecutive patients (the study group consisted of 58 patients, 45 male and 13 female; average age, 39.3 years; range, 13-82 years) who underwent MR arthrography between October 2002 and May 2008 were retrospectively reviewed. The patients were divided into three groups: group A, no shoulder dislocation; group B, first dislocation; and group C, recurrent dislocation. The maximum capsular widths at the anterior, anteroinferior, and inferior regions in the neutral and abducted and externally rotated (ABER) positions were measured on oblique sagittal images. The relationship of capsular width with the number of dislocations, type of capsular attachment, presence of anteroinferior labral tear, and patient sex were evaluated. The sensitivity and specificity of MRI and clinical tests in detecting capsular laxity were also calculated.RESULTS. Among all three patient groups, there were significant differences (p < 0.05) in the widths with the shoulder in the ABER position and the degree of capsular tightening at the anterior region. The average maximum width was largest in group C and smallest in group A. There was a significant difference in the degree of anterior capsular tightening in groups B and C. A moderate correlation of capsular width and anterior tightening (R = -0.45) with number of shoulder dislocations was found. There was a significant difference in capsular width and capsular tightening in relation to the presence of an anteroinferior labral tear. The sensitivity and specificity to detect capsular laxity were 92% and 100%, respectively, for clinical tests and 85% and 96% for MRI.CONCLUSION. MRI is a useful and objective method to assess capsular laxity in patients with recurrent shoulder dislocation.