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Glenoid Dysplasia: Incidence and Association with Posterior Labral Tears as Evaluated on MRI

¹ Department of Radiology, Duke University Medical Center, Box 3808, Duke University Medical Center, Durham, NC 27710.
² Department of Surgery, Division of Orthopedics, Duke University Medical Center, Durham, NC.

View larger version (97K): [in a new window]   Fig. 1A. —Drawings of normal and dysplastic glenoids sectioned in axial plane. Drawing shows normal glenoid and labrum in which posterior glenoid angle and symmetry of posterior and anterior labrum are preserved.

View larger version (109K): [in a new window]   Fig. 1B. —Drawings of normal and dysplastic glenoids sectioned in axial plane. Drawing shows dysplastic glenoid. Note rounding and truncation of posterior glenoid rim with abnormal hypertrophied low- and intermediate-signal posterior labral tissue.

View larger version (36K): [in a new window]   Fig. 2. —Drawings show normal glenoid and labrum and mild, moderate, and severe glenoid dysplasia. For normal glenoid and labrum, posterior glenoid is characterized by pointed posteroinferior glenoid rim with normal-appearing posterior labral tissue. Note symmetry of posterior glenoid with anterior glenoid. In cases of mild glenoid dysplasia, mild rounding or truncation of posteroinferior glenoid rim is seen on one or two sections cephalad to most caudal section. Posterior labrum is normal in appearance or slightly thickened inferiorly. In cases of moderate glenoid dysplasia, rounding-off and truncation of posteroinferior glenoid rim are more marked, often with posterior tilt or sloping of glenoid articular surface. This is associated with abnormally thickened, low-signal soft tissue adjacent to, or replacing, deficient portion of posterior glenoid rim. In severe cases of glenoid dysplasia, rounding, truncation, and posterior sloping of glenoid are extreme. This is associated with abnormally thickened, low-signal posterior soft tissues adjacent to, or replacing, deficient portion of posterior glenoid rim.

View larger version (135K): [in a new window]   Fig. 3. —Normal posteroinferior labrum in 46-year-old man with shoulder pain. T1-weighted axial image (TR/TE, 600/14) from MRI arthrogram of shoulder shows normal slope and pointed rim of posteroinferior bony glenoid (arrow). Size and appearance of posterior labrum are normal, and no evidence of hypertrophied low-signal posterior soft tissue is present.

View larger version (177K): [in a new window]   Fig. 4. —Mild dysplasia of posteroinferior glenoid in 35-year-old man with shoulder pain. T2-weighted axial image from MRI arthrogram of shoulder shows rounding of posteroinferior glenoid rim (arrow). This case is considered mild because hypertrophic soft-tissue signal adjacent to deficient area of glenoid is minimal.

View larger version (165K): [in a new window]   Fig. 5. —Moderate dysplasia of posteroinferior glenoid in 43-year-old man with shoulder pain. T2-weighted axial image (TR/TE, 4,000/73.976) from MRI arthrogram of shoulder shows posterior sloping of glenoid articular surface and truncation of posteroinferior glenoid rim (arrow). There is slight proliferation of abnormal low-signal soft tissue adjacent to bone defect in posterior glenoid. This case is considered moderate because glenoid rim truncation continued cephalad for several more sections without reconstitution of posterior glenoid rim.

View larger version (145K): [in a new window]   Fig. 6A. —Severe dysplasia of posteroinferior glenoid in 43-year-old woman with shoulder pain. T2-weighted noncontiguous axial image (TR/TE, 4,000/73.976) from MRI arthrogram of shoulder shows marked rounding of posteroinferior glenoid with thickened abnormal low-signal soft tissue in place of posterior glenoid rim (arrow).

View larger version (145K): [in a new window]   Fig. 6B. —Severe dysplasia of posteroinferior glenoid in 43-year-old woman with shoulder pain. T2-weighted noncontiguous axial image (4,000/73.976) from MRI arthrogram of shoulder, more cephalad section than that shown in A, shows truncation of posterior glenoid rim and replacement with thickened abnormal low-signal soft tissue (arrow). This case is considered severe because of degree of truncation of posterior glenoid rim, striking thickening of abnormal low-signal posterior soft tissue, and fact that these findings were seen on nearly all sections without reconstitution of posterior glenoid in more cephalad sections.

View larger version (163K): [in a new window]   Fig. 7. —Moderate dysplasia of posteroinferior glenoid with posterior labral tear in 31-year-old man with shoulder pain. T2-weighted axial image (TR/TE, 4,000/73.976) from MRI arthrogram of shoulder shows posterior sloping of glenoid articular surface, rounding of posteroinferior glenoid rim, and hypertrophied low-signal soft tissue. Note fluid signal within substance of abnormally hypertrophied posterior labral tissue indicating posterior labral tear (arrow).

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