Shoulder MRI in diagnostic evaluation of shoulder joint instability: A comparison with shoulder arthroscopy

Abstract

Background: Shoulder joint is an extremely mobile joint with reduced stability. Pain and discomfort due to shoulder joint instability is common cause of orthopedic referrals in young individuals. Diagnostic Arthroscopy is the gold standard in evaluation and planning of definitive repair surgeries. Recent advancements in MR technology with increased accessibility of the general population to MR facilities have enabled non-invasive detection of pathologies associated with shoulder instability. The present study was aimed at determining the diagnostic value of shoulder MRI in shoulder instability as compared to arthroscopy.Materials and Methods: MRI and subsequent arthroscopic evaluation of 182 patients with shoulder pain and instability admitted to a busy orthopedic referral center was done after performing adequate clinical examination and necessary investigations. Results: Sensitivity and specificity of MRI was 95.87% & 89.41%, for detection of Bankart’s lesion, 98.24% & 93.24% respectively for Hill Sach’s lesion and 86.36% & 97.37% respectively for SLAP tears. High sensitivity and specificity was also found for rotator cuff tears.Conclusion: MRI can give an adequate information with regards to the pathology involved in shoulder instability and can help provide valuable input in planning of repair surgeries and can very well help to avoid unnecessary arthroscopic procedure.