Simple Method of Glenoid Bone Loss Calculation Using Ipsilateral Magnetic Resonance Imaging

Abstract

Background: Current methods for estimating glenoid bone loss in patients with chronic shoulder instability include computed tomography imaging with 3-dimensional reconstruction, specialized computer software, and imaging of the contralateral shoulder. An ideal method of glenoid measurement would require only magnetic resonance imaging (MRI) of the injured shoulder. Purpose: To determine whether MRI measurement of glenoid height, as well as sex, could be used to estimate glenoid width in healthy subjects with no history of shoulder instability. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Bilateral shoulder MRIs were obtained in a healthy cohort of young athletes as part of the baseline assessment in a prospective cohort study. A musculoskeletal radiologist measured glenoid height and width using the sagittal MRI cuts. Univariate and multivariate regression analyses were performed to determine whether demographic and MRI measurements of the glenoid could be used to estimate glenoid width. Results: Of the 1264 shoulder MRIs evaluated, the mean glenoid width was 26.67 mm (±2.49 mm), and the mean glenoid height was 42.15 mm (±3.00 mm). There were significant differences between the 129 female glenoids and the 1035 male glenoids for both width (23.1 mm, 27.1 mm, respectively, P < .0001) and height (37.9 mm, 42.7 mm, respectively, P < .0001); however, the relationship between glenoid height and width was similar for both men and women. The glenoid width was found to correlate with the height measurement (r = 0.56) for the entire cohort. Based on the results of linear regression analysis, controlling for the influence of sex, a formula was created that represents the relationship between these variables for male subjects: Glenoid Width = (1/3 Height) + 15 mm. Female patients are estimated with a formula that represents the same slope but a different intercept: W = 1/3 H + 13 mm. Conclusion: Significant differences in glenoid height and width were found by sex; however, the relationship between height and width was similar. These variables are correlated, and the resultant formula can be used to estimate the expected glenoid width in a patient with bone loss. This formula allows for easy calculation of the amount of glenoid bone loss with only a ruler and an MRI of the injured shoulder.