Sublabral foramen and buford complex: inferior extent of the unattached or absent labrum in 50 patients.

Abstract

To determine the inferiormost extent of the anterosuperior labral variants on conventional transverse MR images. We reviewed transverse MR images in 50 consecutive patients with a sublabral foramen or Buford complex at arthroscopy. Images were randomly mixed with those of 58 patients with either a normal labrum (n = 20) or an anterior labral tear (n = 38) at arthroscopy. MR imaging was fat suppressed fast spin echo intermediate or T2 weighted (repetition time msec/effective echo time msec, 1,800-3,000/30-102). Two radiologists evaluated by means of consensus the anterior labrum while blinded to patient history and arthroscopic results. Transverse images obtained through the glenoid fossa were totalled to determine the midpoint. Sensitivity, specificity, and accuracy of MR for depicting a sublabral foramen or Buford complex were calculated along with 95% CIs, by using surgical findings as the reference standard. The sensitivity of MR for diagnosing a sublabral foramen or Buford complex was 0.94 (47 of 50 patients, 95% CI: 0.87, 1.00), specificity was 0.80 (16 of 20 patients, 95% CI: 0.62, 0.97), and accuracy was 0.90 (63 of 70 patients, 95% CI: 0.82, 0.97). The anterior labrum was abnormal on the first transverse section inferior to the midpoint in nine (18%) patients. The labrum was also abnormal on the second section below the midpoint in three (6%) patients. Because of the anterior tilt of the scapula, the midpoint was near the anterior glenoid notch at about the position between 2- and 3-o'clock. The labrum may be unattached or absent on the first two transverse images obtained below the midpoint.