The glenolabral articular disruption lesion: MR arthrography with arthroscopic correlation

OBJECTIVE. The purpose of this study was to describe the MR arthrography ap pearance of the glenolabral articular disruption (GLAD) lesion. Proper diag nosis of this lesion is important because it can be a source of persistent shoulder pain that requires surgical repair and because it is often difficu lt to diagnose clinically. MATERIALS AND METHODS, Findings on MR arthrography were retrospectively cor related with the clinical histories and physical examination findings of si x patients in whom we saw the typical appearance of the GLAD lesion. Four o f these patients underwent follow-up arthroscopy that included surgical pro of of GLAD lesions. RESULTS, Five of the six patients had a documented glenohumeral impaction i njury associated with an abducted externally rotated shoulder. All six pati ents had persistent shoulder pain, but their shoulders were stable during r outine examination. In all patients, MR arthrography showed a superficial t ear of the anteroinferior labrum with an adjacent articular cartilage injur y. The tom labrum remained firmly attached to the anterior scapular periost eum, and contrast material was seen to extend into the labral fear and cart ilaginous defect. CONCLUSION. The MR arthrography findings of GLAD lesions include a nondispl aced tear of the anteroinferior labrum with an adjacent chondral injury. Th e pattern of chondral injury can range from a cartilaginous flap tear to a depressed osteochondral injury of the articular cartilage and underlying bo ne.