Gleno-humeral instabilities |
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Authors: | A Blum H Coudane D Molé |
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Institution: | Service d'Imagerie Guilloz, Hopital Central, CHU Nancy, F-54035 Nancy Cedex, France. |
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Abstract: | The purpose of this review is to highlight the most efficient imaging exploratory techniques depicting shoulder instability,
to describe its various forms and to point out the findings which can simulate instability. In anterior recurrent dislocation,
surgery is indicated and the procedure essentially depends on the importance of glenoid rim lesions. In this case, a standard
X-ray evaluation is usually sufficient. The CT arthrography or MRI techniques give more specific details as to the severity
of the lesions, particularly soft tissues alterations; however, these data do not alter standard therapeutic protocol. In
fixed posterior dislocations, CT scan represents the most pertinent technique to evaluate the size of the humeral head defect
and to determine the therapeutic follow-up. In subtle forms of instability, diagnosis or instability direction are not clearly
assessed clinically and standard X-ray evaluation is usually unremarkable. In this case, further exploration, such as CT arthrography,
MR imaging or MR arthrography, are recommended to confirm the diagnosis of instability and to evaluate its direction. The
technique of choice is undoubtedly MR arthrography. Atraumatic voluntary painless subluxations associated with hyperlaxity
of the shoulder do not require any specific exploratory method because the findings are generally limited to a capacious axillary
pouch.
Received: 28 September 1998; Revised: 21 January 1999; Accepted: 22 March 1999 |
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Keywords: | : Shoulder – Dislocation – MRI – Arthrography – Instability |
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