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Sonography of the Glenoid Labrum

A Cadaveric Study with Arthroscopic Correlation

¹ Department of Radiology, University of Michigan Medical Center, 1500 E. Medical Center Dr., TC 2910, Ann Arbor, MI 48109-0326.
² Department of Radiology, University of Arizona HSC, 1501 N. Campbell Ave., Tucson, AZ 85724-5067.
³ Radia Medical Imaging, Evergreen Hospital Medical Center, 12040 N.E. 128th St., Kirkland, WA 98034.
⁴ Section of Orthopaedic Surgery, University of Michigan Health System, 24 Lloyd Wright Dr., Box 0363, Ann Arbor, MI 48106.
⁵ Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th St., New York, NY 10021.

OBJECTIVE. We assessed the usefulness of sonography in evaluating the glenoid labrum in cadaveric specimens using arthroscopy as a standard of reference.

MATERIALS AND METHODS. Eighty labral quadrants in 20 cadaveric shoulders were examined by two musculoskeletal radiologists using 5- to 7-MHz linear and curvilinear transducers. Agreement was reached by consensus. After sonography, arthroscopy was performed by an experienced orthopedic surgeon. Each labral quadrant was classified at the time of sonography and arthroscopy as normal, degenerated, or torn.

RESULTS. Concordance between sonography and arthroscopy was 86% (69/80 quadrants). In differentiating abnormal labrum (tear or degeneration) from normal labrum using sonography, sensitivity was 63%, specificity was 98%, positive predictive value was 94%, negative predictive value was 86%, and accuracy was 88%. In differentiating labral tears from other labral conditions (degeneration or normality), sensitivity was 67%, specificity was 99%, positive predictive value was 67%, negative predictive value was 99%, and accuracy was 98%.

CONCLUSION. Sonography has a promising role in the evaluation of the glenoid labrum, particularly in excluding labral tears when the labra appear normal on sonography. Further studies are required using normal and symptomatic patients to determine the usefulness of sonography in the diagnosis of labral abnormalities.

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