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MR Imaging and MR Arthrography of Paraglenoid Labral Cysts

¹ Department of Diagnostic Imaging, Brown University School of Medicine, Rhode Island Hospital, 593 Eddy St., Providence, RI 02903.
² Department of Orthopedic Surgery, Brown University School of Medicine, Rhode Island Hospital, Providence, RI 02903.
³ Bayside Orthopaedics, 300C Faunce Corner Rd., North Dartmouth, MA 02747.

OBJECTIVE. We investigated the pathophysiology of paraglenoid labral cysts on the basis of MR imaging, MR arthrography, and cyst aspiration.

MATERIALS AND METHODS. From 2211 MR imaging examinations, 51 (2.3%) cysts in 46 patients were identified. MR arthrography, (n = 5), cystography (n = 1), arthroscopy (n = 17), percutaneous needle aspiration (n = 4), and medical records were also reviewed (n = 46).

RESULTS. On MR imaging and arthrography, cysts were best viewed on T2-weighted images. Mean cyst diameter and volume were 2.2 cm and 2.8 cm³, respectively. Fifty-seven percent of cysts were located adjacent to the posterior labrum. On MR imaging and arthroscopy, a labral tear was identified in 27 (53%) and 15 (88%) patients, respectively. Eight cysts that caused compression neuropathy were large (mean size, 3.1 cm; p = 0.04) and located next to the posterior or inferior labrum. In four of five patients, MR arthrograms showed no intraarticular contrast material in the cyst. Cystograms showed no communication with the gleno-humeral joint space, and cyst aspiration resulted in temporary symptom relief; however, cysts recurred in three of four patients.

CONCLUSION. Most paralabral cysts are associated with labral tears. Paralabral cysts may be difficult to identify on MR arthrography unless a T2-weighted sequence is performed. Direct communication between a cyst and joint space rarely occurs. A posterior or inferior cyst may cause compression neuropathy of the suprascapular or axillary nerve, respectively. Cyst aspiration may result in temporary relief of symptoms, but an untreated labral tear should be suspected if cysts recur.

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