Role of Magnetic Resonance Arthrography (MRA) in the Diagnosis of Shoulder Injuries

Imaging continues to have a crucial role in evaluating patients with shoulder pain, helping to make treatment choices. Magnetic resonance arthrography (MRA), rather than magnetic resonance imaging (MRI), is now routinely used to diagnose shoulder injuries. Against the gold standard investigation of arthroscopy, the study aimed to determine the accuracy of MRA in the evaluation of shoulder injuries.

From June 2017 to May 2019, a cross-sectional study was conducted in a tertiary care health setup in North India. A total of 50 individuals were enrolled for diagnostic imaging with rotator cuff (RC) pathology. Patients were assessed using an MRA and their clinical history. In comparison with the gold standard for arthroscopy, the sensitivity (Sn), positive predictive value (PPV), and diagnostic accuracy (DA) of MRA for diagnosing shoulder injuries were evaluated. A P value under 0.05 was taken to be statistically significant.

The mean ± standard deviation (SD) age of the patients was 37.32 ± 12.78 years. There were seven women and 43 (86%) men. The different lesions were superior labral anterior-posterior (SLAP) tear (24 (48%)), Bankart lesions (19 (38%)), anterior labral periosteal sleeve avulsion (ALSPA) (4 (8%)), partial articular supraspinatus tendon avulsion (PASTA) lesion (2 (4%)), and Buford lesions (1 (2%)). The Sn, PPV, and DA of MRA were 98%, 100%, and 98%, respectively, for identifying the shoulder injury.

It was concluded that MRA was reasonably accurate at diagnosing shoulder injuries. MRA demonstrated an excellent 98% Sn in identifying shoulder injuries and missed only one case of shoulder injury, suggesting that it can be an advantageous imaging tool for recognizing and evaluating shoulder injuries for immediate diagnosis and management.