Diagnosis of frozen shoulder with the coracohumeral ligament on the coronal oblique plane by MRI / 局解手术学杂志

Objective To evaluate the diagnosis of frozen shoulder with the coracohumeral ligament on the coronal oblique plane with MRI.Methods There were 60 patients(120 shoulder joints)in control group,with 30 males and 30 females,the mean age was 50.5 years old.There were 72 shoulder joints in 72 patients of frozen shoulder group(50 femles and 22 males with a mean age of 53.5 years)with clini-cal evidence and MR imaging evidence of frozen shoulder.These were prospectively analyzed to identify the CHL visualization rate and meas-ure the maximum thickness of the CHL.Results The CHL visualization rate on the coronal oblique plane in the control group was 86.7%(104 /120),and the frozen shoulder group was 87.5%(63 /72),the difference was not significant(P >0.05).The CHL visualization rate on the axial view in the frozen shoulder group was 19.4%(14 /72)and the control group was 24.2%(29 /120),the difference was not signifi-cant(P >0.05).The CHL thickness on the coronal oblique plane (n =63)in the patients with frozen shoulder was (4.37 ±1.71)mm, which was significantly greater than (2.84 ±0.79)mm ofpatients in the control group(n =104),the difference was significant(P <0.001). The CHL thickness on the axial plane(n =14)in the patients with frozen shoulder was (3.93 ±1.49)mm,which was significantly greater than (2.29 ±0.65)mm of patients in the control group(n =29),the difference was significant(P <0.001).Conclusion A thickened CHL is highly suggestive of frozen shoulder,which is 4.37 mm on the coronal oblique plane.

Ectopic Insertion of the Pectoralis Minor Tendon: Inter-Reader Agreement and Findings in the Rotator Interval on MRI

OBJECTIVE: To evaluate magnetic resonance imaging (MRI) observer variability to detect ectopic insertion of the pectoralis minor tendon (EIPMT) and to investigate changes in the rotator interval in patients with EIPMT using MRI. MATERIALS AND METHODS: A total of 507 shoulder MRIs (male:female = 259:248; mean age, 55.4 years) were classified into 1) normal type insertion of the pectoralis minor tendon, 2) complete type EIPMT, and 3) partial type EIPMT independently by two radiologists. Inter-observer agreement was calculated using the kappa coefficient. Thickness of the fibrotic scar tissue in the subcoracoid triangle and humeral side axillary recess was measured. MRIs were reviewed by consensus with regard to the grade of fibrotic scar tissue proliferation in the rotator interval. Comparisons were made between normal and EIPMT and between partial and complete type EIPMT. RESULTS: The incidence of EIPMT was 13.4% (complete type, 7.7%; partial type, 5.7%). Inter-observer agreement was substantial (kappa = 0.775). Fibrotic scar tissue in the subcoracoid triangle was thicker, and the grade of fibrotic scar tissue proliferation in the rotator interval was higher in the EIPMT group than those in the control group. No significant difference was observed in the thickness of humeral side axillary recess. The thicknesses of fibrotic scar tissue in the subcoracoid triangle and humeral side axillary recess as well as the grade of fibrotic scar tissue in the rotator interval were not significantly different between complete and partial type EIPMT. CONCLUSION: MRI enabled detection of EIPMT with substantial observer agreement. Patients with EIPMT show a high tendency for fibrotic scar tissue proliferation in the rotator interval.

Arthroscopic Bankart Repair and Rotator Interval Plication by Transglenoid Technique: Preliminary Report / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical results of arthroscopic Bankart repair and rotator interval plication by the transglenoid technique on Traumatic Unidirectional Bankart Surgery (TUBS) with concomitant rotator interval widening. MATERIALS AND METHODS: From May 2002 to May 2003, 13 cases who underwent arthroscopic Bankart repair and rotator interval plication by the transglenoid technique were studied, out of the 14 cases that were diagnosed as TUBS with concomitant rotator interval widening. Follow up period was at least 1 year. Results were evaluated by Rowe score before and after surgery. RESULTS: All the cases were male. Nine cases were on the right shoulder and 4 on the left. The mean age was 22 years old (range, 14-26 years old). The mean duration from injury to operation was 4.3 (range, 1.3-10) years. The Rowe score was improved from 58.3 to 86.4 (p=0.00). Overall outcomes were excellent in 10 cases, good in 2 and fair in 1 at final follow up. There was no sulcus sign in any of the cases at the last follow up, and redislocation did not appear in any of the cases during the follow up period. CONCLUSION: In the treatment of TUBS with concomitant rotator interval widening, arthroscopic Bankart repair and rotator interval plication by the transglenoid technique have made good results.