Sublabral clefts and recesses in the anterior, inferior, and posterior glenoid labrum at MR arthrography

Abstract

To determine the prevalence of a normal variant cleft/recess at the labral-chondral junction in the anterior, inferior, and posterior portions of the shoulder joint. One hundred and three consecutive patients (106 shoulders) who had a direct MR arthrogram followed by arthroscopic surgery were enrolled in this IRB-approved study. Scans were carried out on a 1.5-T scanner with an eight-channel shoulder coil. The glenoid rim was divided into eight segments and the labrum in all but the superior and anterosuperior segments was evaluated by two radiologists for the presence of contrast between the labrum and articular cartilage. We measured the depth of any cleft/recess and correlated the MR findings with surgical results. Generalized estimating equation models were used to correlate patient age and gender with the presence and depth of a cleft/recess, and Cohen's kappa values were calculated for interobserver variability. For segments that were normal at surgery, a cleft/recess was present within a segment on MR arthrogram images in as few as 7 % of patients (within the posteroinferior segment by observer 1), and in up to 61 % of patients (within the posterosuperior segment by observer 1). 55-83 % of these were only 1 mm deep. A 2- to 3-mm recess was seen within 0-37 % of the labral segments, most commonly in the anterior, anteroinferior, and posterosuperior segments. Age and gender did not correlate with the presence of a cleft/recess, although there was an association between males and a 2- to 3-mm deep recess (p = 0.03). The interobserver variability for each segment ranged between 0.15 and 0.49, indicating slight to moderate agreement. One-mm labral-chondral clefts are not uncommon throughout the labrum. A 2- to 3-mm deep smooth, medially curved recess in the anterior, anteroinferior or posterosuperior labrum can rarely be seen, typically as a continuation of a superior recess or anterosuperior labral variant.