New multidetector computed tomography quantitative technique in evaluation of shoulder instability

Aim

This study aimed to assess the role of multidetector computed tomography (MDCT) in detection and evaluation of severity of glenoid and humeral head bone loss in cases of recurrent anterior shoulder joint dislocation.

Patients and methods

Twenty four patients were included in the study. MDCT with 3D VR examination was performed to both shoulders of all patients. The area of the missing glenoid was calculated as well as glenoid track and Hill-Sachs interval in cases of humeral head bone loss. The findings were compared with the intra operative arthroscopic results.

Results

MDCT could detect minimal glenoid bone loss in 19 patients (79.2%), moderate glenoid bone loss in 4 patients (16.7%) and severe glenoid bone loss in 1 patient (4.2%), while arthroscope detected minimal loss in 16 patients (66.7%), moderate glenoid bone loss in 7 patients (29.2%) and significant glenoid bone loss in 1 patient (4.2%). Off-track Hill-Sachs lesions were detected by MDCT in 40% of patients and reduced to 35% of patients by arthroscopy.

Conclusion

MDCT is an optimal imaging modality in preoperative evaluation of glenoid and humeral head bone loss. It is the most accurate radiologic method in evaluating the new concepts of on-track and off- track Hill-Sachs lesions.