However, noncontrast MRI is considered inferior to MR arthrography for assessing labroligamentous pathology frequently associated with Bankart and Hill-Sachs lesions [17,19]. Noncontrast MRI is a good alternative to MR arthrography in the setting of acute injury when significant glenohumeral joint effusion is present to assist in visualization of intra-articular soft-tissue pathology. MR Arthrography Shoulder MR arthrography is the preferred study for evaluating subacute or chronic Bankart lesions because of its soft- tissue contrast. Multiple studies have shown MR arthrography to be reliable in diagnosing labroligamentous injuries [12,17,52] and superior to noncontrast MRI for this indication [17,19]. MR arthrography has been shown to be equivalent to CT in the assessment of glenoid and humeral head bone loss [12,18], while being superior to CT in assessment of labroligamentous injuries [12]. MR arthrography is also able to delineate humeral head and glenoid cartilage, which can be important because some Hill-Sachs lesions affect cartilage only [11]. CT Shoulder Noncontrast CT has historically been used to assess Hill-Sachs and bony Bankart lesions. However, MRI has been shown to be equivalent to CT for assessing both glenoid and humeral head bone loss [12,18,53], and CT is limited in the assessment of cartilaginous Hill-Sachs lesions [11]. In addition, CT cannot assess injury to soft-tissue structures like the labroligamentous complex, which further limits its usefulness in evaluating Bankart lesions. CT should be reserved for patients with a contraindication to MRI or patients in whom MRI assessment of bone loss is limited. CT Arthrography Shoulder CT Arthrography Shoulder CT arthrography has shown fair agreement between observers and is comparable to MR arthrography in diagnosing Bankart and Hill-Sachs lesions [12,13]. However, CT arthrography is inferior to MRI in diagnosing other soft-tissue pathology [12].
Shoulder Pain Traumatic PCAs. However, noncontrast MRI is considered inferior to MR arthrography for assessing labroligamentous pathology frequently associated with Bankart and Hill-Sachs lesions [17,19]. Noncontrast MRI is a good alternative to MR arthrography in the setting of acute injury when significant glenohumeral joint effusion is present to assist in visualization of intra-articular soft-tissue pathology. MR Arthrography Shoulder MR arthrography is the preferred study for evaluating subacute or chronic Bankart lesions because of its soft- tissue contrast. Multiple studies have shown MR arthrography to be reliable in diagnosing labroligamentous injuries [12,17,52] and superior to noncontrast MRI for this indication [17,19]. MR arthrography has been shown to be equivalent to CT in the assessment of glenoid and humeral head bone loss [12,18], while being superior to CT in assessment of labroligamentous injuries [12]. MR arthrography is also able to delineate humeral head and glenoid cartilage, which can be important because some Hill-Sachs lesions affect cartilage only [11]. CT Shoulder Noncontrast CT has historically been used to assess Hill-Sachs and bony Bankart lesions. However, MRI has been shown to be equivalent to CT for assessing both glenoid and humeral head bone loss [12,18,53], and CT is limited in the assessment of cartilaginous Hill-Sachs lesions [11]. In addition, CT cannot assess injury to soft-tissue structures like the labroligamentous complex, which further limits its usefulness in evaluating Bankart lesions. CT should be reserved for patients with a contraindication to MRI or patients in whom MRI assessment of bone loss is limited. CT Arthrography Shoulder CT Arthrography Shoulder CT arthrography has shown fair agreement between observers and is comparable to MR arthrography in diagnosing Bankart and Hill-Sachs lesions [12,13]. However, CT arthrography is inferior to MRI in diagnosing other soft-tissue pathology [12].