肩关节损伤的MR影像诊断

目的 探讨常规MRI和MR间接关节造影对肩关节损伤的诊断价值.方法 回顾分析经关节镜证实的90例肩关节损伤患者肩关节常规MRI和MR问接关节造影表现,其中肩袖病变组57例、盂肱关节不稳组33例.对常规MRI和MR间接关节造影诊断结果进行Fisher确切概率法比较.结果 (1)肩袖病变组中MR间接关节造影37例,显示部分撕裂10例,1例漏诊;显示完全撕裂17例,2例误诊,7例肩袖无撕裂.MR间接关节造影显示部分撕裂的敏感度、特异度、准确度分别为90.9%(10/11)、92.3%(24/26)、91.9%(34/37);显示完全撕裂的敏感度、特异度、准确度分别为89.5%(17/19)、94.4%(17/18)、91.9%(34/37).MR间接关节造影诊断肩袖部分及完全撕裂的敏感度及准确度均高于常规MRI(P<0.05).(2)盂肱关节不稳组中,盂唇损伤26例,Hill-sachs病变27例、反Hill-sachs病变2例、骨陛Bankart损伤7例、关节囊损伤18例.间接关节造影20例,显示盂唇损伤14例,1例漏诊,5例正常.MR间接关节造影显示盂唇损伤的敏感度、特异度、准确度分别为93.3%(14/15)、100.0%(5/5)、95.0%(19/20).前者诊断盂唇损伤的敏感度及准确度明显高于常规MRI(P<0.05).结论 MR检查特别是MR间接关节造影能够准确显示肩关节常见病变及相关组织的病理发展过程,为临床诊断及治疗提供影像学依据.     

MRI对肩袖撕裂的诊断价值

目的 评价肩关节MRI对肩袖撕裂的诊断价值,并分析其影像特征及损伤机制.方法 回顾性分析76例肩袖撕裂的MRI表现及临床症状.结果 肩袖全层撕裂共25例.其中冈上肌腱撕裂23例,同时向冈下肌腱延伸5例,6例合并肩胛下肌腱部分撕裂,1例合并肱二头肌长头腱断裂,2例合并关节盂前上盂唇撕脱.肩袖部分撕裂共51例,全部发生在冈上肌腱.其中上表面侧11例,下表面侧32例,肌腱内部分撕裂8例.其中8例同时在上表面及下表面发生部分撕裂,3例同时合并下表面及肌腱内部分撕裂.结论 肩关节MRI是评价肩袖撕裂比较有效的检查方法,为临床制定正确的治疗方案提供可靠的依据.     

0.35T MRI在肩撞击综合征中的应用

目的 探讨0.35T MRI检查在肩撞击综合征中的应用.方法 对20例肩关节疼痛患者的MRI影像学资料进行分析.结果 磁共振成像显示冈上肌肌腱信号异常者5例,肩袖撕裂者6例,肩关节唇盂撕裂1例,关节囊及滑囊积液者4例,肱骨大结节陈旧性撕脱骨折者4例.结论 0.35T MRI能够清晰显示肩撞击综合征的影像特征,对于临床的诊断及治疗具有较大的价值.     

肩关节损伤的MR关节造影与MRI对比研究

目的探讨肩关节MR关节造影与常规MRI检查阳性率的敏感性及特异性,并探讨哪类患者更适用于MR关节造影。方法选取100例肩痛患者先后行肩关节常规MRI和MR关节造影检查,图像分别由两位有经验的放射医师盲法评价,评估盂唇撕裂和冈上肌肌腱撕裂;所有患者均行关节镜检查并与MRI及MR关节造影结果分别做对照分析。结果 100例患者中,在常规MRI检查评价者1中共有43例上盂唇前后(SLAP)撕裂,28例后盂唇撕裂,23例前盂唇撕裂和47例冈上肌肌腱撕裂;评价者2中有42例SLAP撕裂,26例后盂唇撕裂,24例前盂唇撕裂和47例冈上肌肌腱撕裂。在MR关节造影检查评价者1中有51例SLAP撕裂,33例后盂唇撕裂,29例前盂唇撕裂和49例冈上肌肌腱撕裂;评价者2中有50例SLAP撕裂,31例后盂唇撕裂,30例前盂唇撕裂和49例冈上肌肌腱撕裂。MR关节造影评价者1和2中均额外发现8例SLAP撕裂,5例后盂唇撕裂,6例前盂唇撕裂和2例冈上肌肌腱撕裂,而这些在常规MRI检查中均未发现。48例常规MRI检查正常中有21例在MR关节造影检查中发现额外异常;52例患者常规MR检查异常中仅有3例在MR关节造影检查中发现额外异常结果。结论常规MRI检查异常时再行MR关节造影检查能显示的额外阳性信息很少,这类患者可不需要MR关节造影检查;常规MRI检查为阴性患者再行MR关节造影检查可发现额外异常结果。     

肩胛肌肉强化训练治疗慢性肩袖损伤临床研究

目的:探讨肩胛肌肉强化训练治疗慢性肩袖损伤后功能障碍的临床疗效。方法:选择肩袖损伤肩关节功能障碍患者48例,随机分为对照组(22例)和治疗组(26例)。对照组进行理疗、运动疗法及关节松动术,l次/日,10次为1个疗程,共进行2个疗程,各疗程间无间隔。治疗组增加肩胛肌肉强化训练康复手段,包括对冈上肌、冈下肌、小圆肌、肩胛提肌、菱形肌、上下斜方肌、背阔肌等进行牵伸、松解、稳定性和本体感觉训练等系统康复手段。所有患者于治疗前后行肩关节活动范围(ROM)和UCLA肩关节功能评分系统评定。结果:纳入患者48例全部进入结果分析。两组患者治疗2个疗程后肩关节ROM及UCLA评分变化:1对照组治疗2个疗程后,肩关节ROM及UCLA评分均提高,与本组治疗前比较差异有显著性意义(P<0.05);2治疗组治疗2个疗程后肩关节ROM及UCLA评分均明显改善,与本组治疗前比较差异有显著性意义(P<0.05);与对照组治疗后比较差异有显著性意义(P<0.05)。结论:肩胛肌肉放松及强化训练改善肩袖损伤患者肩关节活动范围,提高肩关节运动功能的临床疗效显著。     

肩关节损伤MRI与关节镜的对比分析

目的探讨常规MRI对肩关节损伤的诊断价值。方法回顾性分析因肩关节损伤行常规MRI和关节镜检查的55例病人资料,MRI观察指标包括肩袖、盂唇形态及信号,有否肩峰下撞击及骨性损伤。以肩关节镜为诊断金标准,统计MRI对不同类型肩关节损伤的诊断结果,并分别计算MRI的诊断敏感度、特异度和准确度。采用Kappa检验分析MRI与肩关节镜诊断结果的一致性。结果肩关节损伤的MRI征象中分别有25%部分肩袖撕裂、13.3%Bankart’s损伤、20%盂唇上部前后方向(SLAP)损伤和11.6%肩峰下撞击漏诊。MRI诊断损伤性病变的特异度及肩袖全层撕裂(100%)、骨性损伤(100%)、肩峰下撞击(88%)和Bankart’s损伤(87%)的敏感度较高,诊断SLAP损伤(75%)和肩袖部分撕裂(75%)的敏感度较低;诊断肩袖全层撕裂(100%)和骨性损伤(100%)的准确度最高,其次是Bankart’s损伤(96%),诊断SLAP损伤(89%)的准确度较低。MRI和关节镜诊断肩袖全层撕裂、骨性损伤的κ值为1,结果完全一致,诊断Bankart’s损伤的κ值为0.904,一致性较好,诊断肩袖部分撕裂、SLAP损伤和肩峰下撞击的κ值虽稍低,但均0.75,一致性也较好,P均0.05。结论 MRI是有效诊断肩关节损伤的影像方法,但对SLAP损伤和肩袖部分撕裂的诊断准确度有待提高。     

肩关节造影和MRI诊断肩袖损伤

目的评定肩关节造影、MRI诊断肩袖损伤的价值.材料和方法将33例临床诊断肩袖损伤患者的术前关节造影和MRI检查结果与术中观察结果的比较.另有13例复发性肩关节不稳、无肩袖损伤症状和体征的年轻患者术前的关节造影和MRI结果以及术中观察结果作为正常肩袖对照.结果在诊断肩袖完全断裂中,肩关节造影的敏感性为91%,特异性为100%;MRI的敏感性为95%,特异性为88%.结论关节造影诊断肩袖完全撕裂方法简单、迅速且费用低,易于广泛开展.但不能直接显示病变部位.MRI不但能够准确显示断裂的部位,反映肩袖病变的病理过程,而且能同时显示相邻组织的病理改变,更利于诊断和鉴别诊断.     

肩关节CT造影与MRI造影诊断肩关节前脱位的对比研究

目的:探讨CT关节造影与MRI关节造影对肩关节前脱位的诊断价值.方法:对36例(36个患肩)肩关节前脱位患者分别行CT造影与MRI造影,比较2种检查方法对下盂肱韧带损伤、前下盂唇损伤、骨与软骨损伤的检出率,并与肩关节镜或开放手术检查结果对照.结果:36例(36个患肩)中,下盂肱韧带损伤24个(CT造影检出14个,MRI...     

肩峰下撞击综合征合并肩袖撕裂的MR诊断

目的:分析肩峰下撞击综合征合并肩袖撕裂的MRI表现特征,旨在提高对肩袖撕裂影像学的认识.方法:回顾分析17例经关节镜手术证实的肩峰下撞击综合征合并肩袖撕裂病例的临床及MR影像资料.结果.17例肩峰下撞击综合征合并肩袖撕裂的病例:6例肩袖为完全撕裂,撕裂贯穿冈上肌腱全层,MR表现为冈上肌腱部分肌腱纤维不连续,充填液体样高信号,并与关节腔及肩峰下滑囊液体信号相通,部分病例断裂处局部肌腱缺损、肌肉回缩;11例肩袖为部分撕裂,其中4例表现为冈上肌腱滑膜侧部分肌腱纤维断裂,另7例表现为冈上肌腱关节面侧部分肌腱纤维断裂,MR表现为肌腱断裂处充填液体样高信号,或表现为肌腱滑膜侧部分肌腱信号增高,边缘毛糙.结论:MR检查能够直观地显示肩袖的撕裂,准确地显示撕裂的部位、撕裂累及的范围及严重程度,为临床诊疗提供可靠的影像学依据.     

MSCT、MRI联合运用在复发性肩关节前脱位Bankart病损中的应用价值

目的:探讨MSCT、MRI联合运用在复发性肩关节前脱位Bankart病损中的应用价值。方法:回顾性分析经临床、影像证实的复发性肩关节前脱位Bankart病损10例患者的MSCT、MRI表现,主要观察肩关节盂唇前方的CT、MRI改变。结果:10例中,CT发现肩关节盂前下份撕脱性骨折4例,MRI发现肩关节前下盂唇撕脱性骨折1例;MRI发现肩关节盂唇损伤10例,CT不能显示;CT发现合并Hill-Sachs损伤6例,MRI发现Hill-Sachs损伤8例;CT未能发现肱骨头骨挫伤3例;MRI发现肩袖损伤6例,Slap损伤1例。结论:MSCT、MRI能够相互补充,清晰显示Bankart病损及其他合并病变,为临床诊断及治疗提供更加充分的资料。     

Greater tuberosity notch: an important indicator of articular-side partial rotator cuff tears in the shoulders of throwing athletes.

We examined the location of rotator cuff tears, associated labral injuries, and notches on the greater tuberosity of the humeral head in shoulders of throwing athletes. Arthroscopic findings (rotator cuff tear, labral condition, and greater tuberosity notch) as well as other factors (duration of playing baseball, range of motion, and joint laxity) of 61 baseball players were retrospectively studied. The presence of a greater tuberosity notch was also evaluated for by plain radiographs. Forty patients had articular-side partial rotator cuff tears, most of which occurred in the interval between the supraspinatus and infraspinatus tendons. The existence of a rotator cuff tear was not related to the range of motion, joint laxity, the detachment of the superior glenoid labrum, or posterosuperior labral injury. Greater tuberosity notches were recognized in 38 shoulders by arthroscopy and most were detected on plain radiographs. The presence of a notch was significantly related to the existence of a rotator cuff tear, while the size of the notch was significantly related to the depth and width of the tear. The greater tuberosity notch seems to be one of the most important diagnostic indicators for a rotator cuff tear in throwing athletes.     

MR arthrography of the shoulder: comparison with conventional MR imaging

Twenty-three patients underwent both conventional MR imaging of the shoulder and MR shoulder arthrography for clinically suspected labral or rotator cuff abnormalities. Images obtained before and after contrast administration were studied independently, and without knowledge of clinical findings, by two radiologists for the presence of abnormalities of the glenoid labrum or rotator cuff. Results were correlated with surgical findings in all patients. Nine patients had surgically proved labral tears. MR arthrography detected all nine labral abnormalities, while six of the nine were missed on conventional MR imaging. Fourteen patients had surgically proved rotator cuff tears. MR arthrography detected 11 of the 14 tears and missed three partial tears on the bursal surface. Conventional MR imaging detected nine cuff tears and missed five tears; two of these were complete rotator cuff tears and three were partial tears of the undersurface of the rotator cuff. Our results suggest that MR arthrography enhances the accuracy of MR in the evaluation of the glenoid labrum and rotator cuff tendon.     

Evaluation of the rotator cuff and glenoid labrum using a 0.2-Tesla extremity magnetic resonance (MR) system: MR results compared to surgical findings.

The purpose of this investigation was to evaluate the diagnostic capabilities of magnetic resonance imaging (MRI) performed using a dedicated-extremity MR system in detecting lesions of the rotator cuff and glenoid labrum. This retrospective study compared the MR results obtained in 47 patients that underwent MRI using a 0.2-Tesla extremity MR system (E-scan) to the surgical findings. MR images of the shoulder were obtained as follows: shoulder coil, T1-weighted, coronal-oblique and axial images; short Tau inversion recovery (STIR), coronal-oblique images; and T2-weighted, coronal-oblique, sagittal-oblique, and axial images. The MR examinations were interpreted by three highly experienced, musculoskeletal radiologists. Open surgical (N = 26) or arthroscopic (N = 21) procedures were performed within a mean time of 33 days after MRI. The surgical findings revealed rotator cuff tears in 28 patients and labral lesions in 9 patients. For the rotator cuff tears, the sensitivity, specificity, positive predictive value, and negative predictive value were 89%, 100%, 100%, and 90%, respectively. For the labral lesions, the sensitivity, specificity, positive predictive value, and negative predictive value were 89%, 95%, 80%, and 97%, respectively. The findings indicated that there was good agreement comparing the MR results obtained using the low-field extremity MR system to the surgical findings for determination of lesions of the rotator cuff and glenoid labrum. Notably, the statistical values determined for the use of this MR system were comparable to those reported in the peer-reviewed literature for the use of whole-body, mid- and high-field-strength MR systems.     

Ultrasonographic and MR diagnosis of rotator cuff disorders & shoulder joint instability

Objective

To evaluate the role and efficacy of U/S and MR in diagnosis of rotator cuff disorders and shoulder joint instability.

Patients and methods

This study included 30 patients with shoulder pain and/or movement limitation. They underwent shoulder U/S examination followed by MR examination. The U/S & MR diagnostic criteria of each patient were analyzed, compared and correlated with arthroscopic and/or orthopedic surgical findings.

Results

15 patients had with rotator cuff disorders 15/30 (50%) and 11 patients had shoulder instability 11/30 (36.7%). Out of 15 patients with rotator cuff disorders, 12 patients had rotator cuff tears 12/15 (80%) and 3 patients had tendenosis 3/15(20%). The supraspinatus muscle was involved in all cases (100%), without a significant comparable difference between U/S and MR. Out of 11 patients with shoulder instability 8 patients had anterior labral tear 8/11 (72.7%); 2 patients had superior labral tear 2/11 (18.2%) and only one patient with posterior labral tear.

Conclusion

U/S and MRI are valid diagnostic modalities in detecting, characterizing and discriminating the rotator cuff disorders, with no significant comparable difference. U/S has many challenges in patients with shoulder instability, while MR provides accurate diagnosis even without contrast.     

Direct MR arthrography of the shoulder: is exercise prior to imaging beneficial or detrimental?

PURPOSE: To define the beneficial and detrimental effects of adding exercise to direct magnetic resonance (MR) shoulder arthrography. MATERIALS AND METHODS: Direct, intraarticular, gadolinium arthrography of the shoulder was performed in 41 patients, who underwent 1.5-T MR imaging before and after 1 minute of arm swinging. Fourteen milliliters of dilute gadolinium solution was injected. Two readers blinded to exercise independently graded the randomly distributed images with a five-point scale for capsular contrast material resorption; extraarticular contrast material leakage; rotator cuff, glenoid labrum, and anterior capsule conspicuity; and partial-thickness or full-thickness rotator cuff tear and labral tear detectability. The sign test was performed to evaluate the significance of differences between preexercise and postexercise grading for each reader. A second review was performed, with direct side-by-side comparison of preexercise and postexercise images. RESULTS: There was evidence of increased capsular resorption after exercise but no alteration in the depiction of the rotator cuff tendons or glenoid labrum. There was no significant extraarticular contrast material leakage after exercise and no alteration in depiction of the anterior capsule. There was no difference in the detectability of rotator cuff or labral tears. CONCLUSION: Exercise with direct shoulder MR arthrography has no beneficial or detrimental effect on image quality or on the depiction of rotator cuff or labral tears.     

Outcomes of combined arthroscopic rotator cuff and labral repair

BACKGROUND: Rotator cuff tears, Bankart lesions, and superior labral anterior posterior lesions commonly occur in isolation, but there is a subgroup of patients who experience combined injuries. Prior studies have excluded such patients as confounding groups. HYPOTHESIS: In patients with combined lesions of the labrum and rotator cuff, arthroscopic repair of both lesions will restore range of motion and stability and provide good clinical results. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively evaluated the clinical outcomes of a series of patients with combined rotator cuff and labral (Bankart or superior labral anterior posterior) lesions treated arthroscopically. RESULTS: Thirty patients (average age, 47.8 years) with combined rotator cuff and labral lesions were evaluated at a mean follow-up of 2.7 years (range, 24-54 months). Sixteen patients had Bankart lesions and 14 patients had SLAP lesions. Significant improvements in forward flexion (20.5 degrees, P = .005), external rotation (9.0 degrees, P = .008), and internal rotation (2 vertebral levels, P = .016) were observed. The mean L'Insalata and American Society of Shoulder and Elbow Surgeons scores for all patients were 92.9 and 94.3, respectively. Twenty-seven (90%) patients reported satisfaction as good to excellent, and 23 of 30 (77%) returned to their preinjury level of athletics. Two patients suffered recurrent rotator cuff tears. CONCLUSION: In patients with rotator cuff and labral lesions, arthroscopic treatment of both lesions yields good clinical outcomes, restoration of motion, and a high degree of patient satisfaction.     

Distal clavicular osteolysis: MR evidence for subchondral fracture

Purpose To investigate the association between distal clavicular osteolysis and subchondral fractures of the distal clavicle at MRI. Materials and methods This study was approved by the hospital human research committee, which waived the need for informed consent. Three radiologists retrospectively analyzed 36 shoulder MR examinations in 36 patients with imaging findings of distal clavicular osteolysis. The presence of a subchondral fracture of the distal clavicle, abnormalities of the acromioclavicular joint, rotator cuff tears and labral tears were assessed by MRI. These cases were then compared with 36 age-matched controls. Results At MRI, 31 of 36 patients (86%) had a subchondral line within the distal clavicular edema, consistent with a subchondral fracture. Of the 36 patients, 32 (89%) had fluid in the acromioclavicular joint, while 27 of 36 patients (75%) had cysts or erosions in the distal clavicle. There were 13 patients (36%) with associated labral tears, while eight patients (22%) had partial-thickness rotator cuff tears. In the control group one of 36 (3%) had a subchondral line (P<0.05), while ten of 36 (28%) had rotator cuff tears and 13 of 36 (36%) had labral tears. These latter two were not statistically significant between the groups. Conclusion A distal clavicular subchondral fracture is a common finding in patients with imaging evidence of distal clavicular osteolysis. These subchondral fractures may be responsible for the propensity of findings occurring on the clavicular side of the acromioclavicular joint.     

Shoulder arthroscopy: its role in evaluating shoulder disorders in the athlete

We retrospectively reviewed 100 initial shoulder arthroscopies from a general sports medicine orthopaedic practice to determine if arthroscopy is helpful diagnostically and to see if specific lesions correlate well with specific diagnoses. Seventy-two percent of the patients in the review had glenoid labral tears. Ninety-two percent of patients who had a diagnosis of either recurrent anterior dislocation or recurrent anterior subluxation demonstrated a tear of the anterior inferior margin of the glenoid labrum. Sixty-eight percent of patients with a diagnosis of impingement demonstrated tears at the superior margin of the labrum. There was a significant difference between throwing and nonthrowing athletes. Partial rotator cuff tears were noted in 18 patients, the majority occurring in throwing athletes. Other abnormalities, such as degenerative joint changes and biceps tendon lesions, were also noted at the time of arthroscopy. A large number of glenoid labral tears found at the time of arthroscopy appeared to be associated with conditions other than instability, which may or may not affect the throwing athlete. There also appeared to be a high correlation between tears in the anterior inferior glenoid labrum and anterior instability. Arthroscopy enabled us to identify other significant information about the status of the biceps tendon or the undersurface of the rotator cuff. These are areas in which problems might otherwise have been missed. Degenerative changes of the articular surface, not apparent on plain radiographs, may also be better evaluated arthroscopically.     

Shoulder MR arthrography: which patient group benefits most?

OBJECTIVE: We sought to compare the diagnostic accuracy of conventional MRI versus MR arthrography of the shoulder in the assessment of high-performance athletes (professional baseball players) and to compare our findings in these patients with the conventional MRI and MR arthrographic findings in an age-matched control group of nonprofessional athletes. MATERIALS AND METHODS: Conventional MRI and MR arthrographic examinations of the shoulder in 20 consecutive professional baseball players with shoulder pain were reviewed retrospectively by two musculoskeletal radiologists in consensus. These interpretations were compared with retrospective consensus interpretations of conventional MRI and MR arthrographic examinations of the shoulder obtained in a control group of 50 consecutive nonprofessional athletes with shoulder pain. MR images were assessed for full- or partial-thickness supraspinatus tendon tears, superior labral anteroposterior (SLAP) tears, and anterior or posterior labral tears. RESULTS: In the 20 consecutive professional athlete patients, two full-thickness and six partial-thickness undersurface supraspinatus tendon tears were seen on MR arthrography but not seen on conventional MRI as well as six SLAP tears, two anterior labral tears, and one posterior labral tear. Three patients had both SLAP tears and full- or partial-thickness supraspinatus tendon tears. Of 14 patients with findings on MR arthrography that were not seen on MRI, 11 had arthroscopic correlation. In all 11, arthroscopic findings confirmed findings on MR arthrography. In the group of 50 nonprofessional athlete patients, five had additional findings on MR arthrography not seen on conventional MRI: two anterior labral tears, two partial-thickness supraspinatus tendon tears, and two SLAP tears. One patient had both a partial-thickness supraspinatus tendon tear and a SLAP tear seen on MR arthrography. The five patients with additional findings on MR arthrography had arthroscopy. In all five, arthroscopic findings confirmed the findings on MR arthrography. CONCLUSION: MR arthrography is considerably more sensitive for detection of partial-thickness supraspinatus tears and labral tears than conventional MRI. MR arthrography showed injuries in addition to those seen on conventional MRI in 14 of 20 patients in the high-performance athlete group. These results suggest high-performance athletes may be a subgroup of patients for whom MR arthrography yields considerably more diagnostic information than conventional MRI.     

Capsulo-labro-ligamentous lesions of the shoulder: evaluation with MR arthrography

PURPOSE: The aim of the study was to analyse the accuracy of MR arthrography in the evaluation of capsulo-labro-ligamentous lesions of the shoulder in patients with glenohumeral joint instability. MATERIALS AND METHODS: From 1999 to 2001 fifty-eight patients with glenohumeral joint instability were studied by MR arthrography. Twenty-seven patients underwent surgical repair: 11 by arthroscopic and 16 by arthrotomic approach. All shoulder evaluations were performed with T1 and T2 weighted axial, coronal and sagittal oblique images, before and after intra-articular injection of gadolinium contrast. RESULTS: Forty capsulo-ligamentous lesions (including 14 capsular ruptures with extravasation of the contrast medium) were detected by MR arthrography. Fifty-two labral tears (36 of the anterior, 13 of the superior and 3 of the posterior glenoid labrum) were identified: 11 out of 52 were not recognized before gadolinium contrast injection. Five rotator cuff tears were identified, one of which was not shown in the pre-injection examination. Surgical results confirmed the MR arthrographic findings in 25/27 patients. In one case MR arthrography did not recognize a SLAP lesion; in another case it identified a tear of the capsule but not of the glenoid labrum. CONCLUSIONS: In many cases of subacute glenohumeral joint lesions with intracapsular fluid, MR may accurately evaluate capsulo-labral-ligamentous lesions. Indeed, the examination of lesions is limited by the absence of the natural contrast determined by fluid; in such cases, intra-articular injection of gadolinium contrast is necessary. MR arthrography evaluates the degree of capsulo-labro-ligamentous tears and may guide the surgical approach.