Superior labral anteroposterior lesions: MR arthrography with arm traction.

Abstract

The purpose of this study was to investigate the efficacy of arm traction combined with MR arthrography in the evaluation of superior labral anteroposterior (SLAP) lesions. Cadaveric shoulders were studied with a 1.5-T MR imaging unit with the arm externally rotated. Fifteen milliliters of a gadolinium-containing contrast agent were injected into the glenohumeral joint. Twenty-four sets of images of cadaveric joints were evaluated independently by two observers. These sets consisted of MR arthrographic images obtained with traction (applied to the wrist using 1- to 3-kg weights) and without traction in five shoulders in which SLAP lesions had been excluded arthroscopically or by cadaveric sectioning; and MR arthrographic images obtained with and without traction in seven shoulders in which various types of SLAP lesions had been created arthroscopically and later confirmed by cadaveric sectioning. Analysis of the data indicated that MR arthrography in combination with arm traction and external rotation improved diagnostic accuracy with regard to identification and categorization of SLAP lesions when compared with studies made without traction. The combination of MR arthrography and arm traction with the shoulder in external rotation provides a more effective approach for detection of SLAP lesions than does similar MR arthrography performed without arm traction.