Shoulder: What the Orthopaedic Doctor Needs to Know

ABSTRACT

Diagnosing shoulder pathology accurately requires both clinical expertise and the ability to interpret and correlate radiographic studies. Variational anatomy of the shoulder combined with the complexity of physical examination makes this difficult. Physical examination of the shoulder often leaves the surgeon with more than one working diagnosis. Imaging studies of the shoulder are more valuable if used to confirm a working diagnosis as opposed to reading the study in a vacuum. Clinical correlation should also be considered for any and all findings on an imaging study. Collaboration of the surgeon and the radiologist is essential in reducing the number of over-reported findings that are clinically insignificant. The surgeon should directly communicate with the radiologist as to his or her working diagnosis and the goal of the study. In this way the surgeon and radiologist become superior diagnosticians.

KEYWORDS

Shoulder joint - rotator cuff - joint instability - magnetic resonance imaging

REFERENCES

• 1 Vangsness Jr C T, Jorgenson S S, Watson T, Johnson D L. The origin of the long head of the biceps from the scapula and glenoid labrum: an anatomical study of 100 shoulders.  J Bone Joint Surg Br. 1994;  76 951-954
• 2 Davidson P A, Rivenburgh D W. Mobile superior glenoid labrum: a normal variant or pathologic condition?.  Am J Sports Med. 2004;  32 962-966
• 3 Snyder S J, Karzel R P, Del Pizzo W, Ferkel R D, Friedman M J. SLAP lesions of the shoulder.  Arthroscopy. 1990;  6 274-279
• 4 Palmer W E, Brown J H, Rosenthal D I. Labral-ligamentous complex of the shoulder: evaluation with MR arthrography.  Radiology. 1994;  190 645-651
• 5 Jee W H, McCauley T R, Katz L D, Matheny J M, Ruwe P A, Daigneault J P. Superior labral anterior posterior (SLAP) lesions of the glenoid labrum: reliability and accuracy of MR arthrography for diagnosis.  Radiology. 2001;  218 127-132
• 6 Reuss B L, Schwartzberg R, Zlatkin M B, Cooperman A, Dixon J R. Magnetic resonance imaging accuracy for the diagnosis of superior labrum anterior-posterior lesions in the community setting: eighty-three arthroscopically confirmed cases.  J Shoulder Elbow Surg. 2006;  15 580-585
• 7 Morrison D, Bigliani L. The clinical significance of variations in acromial morphology.  Orthop Trans. 1987;  11 234