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An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System
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It's not a Bennett: How to identify chronic reverse Bankart instability on MRI.

Paul McMillan1, Susan E Braley2, Tim T Klostermeier3

  • 1Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA.

Clinical Imaging
|July 6, 2026
PubMed
Summary

Magnetic Resonance Imaging (MRI) can differentiate Chronic Reverse Bankart Lesions (CRBL) from Bennett lesions using three key features, improving diagnostic accuracy for posterior glenoid calcification in athletes.

Keywords:
InstabilityLabrumMRIShoulderSports medicine

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Sports Medicine

Background:

  • Chronic Reverse Bankart Lesion (CRBL) presents diagnostic challenges due to its radiographic similarity to Bennett lesions.
  • Delayed diagnosis of CRBL can lead to significant long-term complications for athletes.

Purpose of the Study:

  • To identify specific Magnetic Resonance Imaging (MRI) features that differentiate CRBL from Bennett lesions.
  • To evaluate the reliability and accuracy of these MRI features in clinical practice.

Main Methods:

  • Retrospective review of 44 cases with posterior shoulder pain and glenoid calcification on MRI.
  • Independent review of cases by three raters to assess diagnostic accuracy and inter-rater reliability (Fleiss's kappa).

Main Results:

  • Three specific MRI features demonstrated >95% accuracy in distinguishing CRBL from Bennett lesions.
  • High inter-rater reliability (Fleiss's kappa ≥ 0.73) confirmed the consistency of these diagnostic features.

Conclusions:

  • MRI offers a reliable method to accurately differentiate CRBL from Bennett lesions, despite similar radiographic appearances.
  • Improved diagnostic precision through MRI can lead to timely and appropriate treatment for posterior glenoid pathology.