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The normal shoulder: common variations that simulate pathologic conditions at MR imaging

J T Liou1, A J Wilson, W G Totty

  • 1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.

Radiology
|February 1, 1993
PubMed
Summary

Magnetic resonance (MR) imaging of asymptomatic shoulders reveals common findings in the supraspinatus tendon and anterior capsule that can mimic pathology. Understanding these variations is crucial for accurate MR imaging interpretation.

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Area of Science:

  • Orthopedics
  • Radiology
  • Medical Imaging

Background:

  • Asymptomatic shoulder findings on magnetic resonance (MR) imaging can be mistaken for pathology.
  • Accurate interpretation requires understanding normal anatomical variations.

Purpose of the Study:

  • To analyze the appearance of the supraspinatus tendon and anterior capsular mechanism in asymptomatic shoulders using MR imaging.
  • To identify findings that simulate pathologic conditions.

Main Methods:

  • Retrospective analysis of MR imaging in 60 asymptomatic shoulders.
  • Review of T1-weighted and proton-density spin-echo images.
  • Assessment of supraspinatus tendon signal intensity, fat stripe obliteration, acromioclavicular joint arthrosis, and anterior glenoid labrum-glenohumeral ligament (GHL) complex morphology.

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Main Results:

  • Intermediate signal intensity in the supraspinatus tendon, particularly focal intensity in the distal tendon (95%), was common.
  • Focal obliteration of the subacromial-subdeltoid fat stripe (95%) and acromioclavicular joint arthrosis (48%) were observed.
  • Significant variation in the anterior glenoid labrum-GHL complex shape was noted, with potential for mimicking tears.

Conclusions:

  • Many findings in asymptomatic shoulders, such as supraspinatus tendon signal intensity and labral variations, can mimic tears or pathology on MR imaging.
  • Familiarity with these common variations is essential for radiologists to avoid misdiagnosis.
  • This study aids in differentiating normal MR imaging findings from actual shoulder pathology.