Synovial fold of the posterior shoulder joint capsule |
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Authors: | Leon M Novak Joong K Lee Asgar M Saleem |
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Institution: | (1) Department of Radiology, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208, USA;(2) Community Care, Physicians, Inc., ImageCare, Suite 114, 711 Troy-Schenectady Road, Latham, NY 12110, USA |
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Abstract: | Purpose The purpose of the study is to describe, based on shoulder MRI and MR arthrography with arthroscopic correlation, a posterior
joint capsule fold.
Materials and methods A retrospective review of 410 shoulder MRIs and direct MR arthrograms with arthroscopic correlation in positive cases (when
available) was obtained with IRB approval and HIPPA compliance. The study was performed by three musculoskeletal radiologists.
The criteria utilized to establish the diagnosis of posterior synovial fold included: (1) axial T1-weighted (T1W) on MR arthrography
or axial T2* GRE-weighted on MRI demonstrating rounded thickening of the posterior shoulder joint capsule with a thickness
at least 2 mm in diameter. (2) The posterior synovial fold extends in an oblique craniocaudal direction from the posterior–inferior
joint capsule adjacent to the posterior–inferior glenoid labrum (7 o'clock) and continues superiorly away from the glenoid
labrum to the posterior–superior joint capsule (11 o'clock).
Results Although uncommon, the posterior synovial fold was present in 2% (8/410) of studies reviewed and found predominantly in women
(75%, 6/8). Four patients had arthroscopic confirmation of the posterior synovial fold. A higher percentage of posterior synovial
folds were observed on shoulder MR arthrography (2.7%, 4/150) than on shoulder MRI (1.5%, 4/260).
Conclusion Although rare, the posterior synovial fold can be recognized and should not be confused with a posterior labral tear. Further
investigation is needed to assess its histologic properties and its clinical significance. |
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Keywords: | Shoulder MR arthrography Synovial fold MRI Joint capsule |
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