Kj. Stevens et al., CT imaging and three-dimensional reconstructions of shoulders with anterior glenohumeral instability, CLIN ANAT, 12(5), 1999, pp. 326-336
Glenohumeral instability is a common occurrence following anterior dislocat
ion of the shoulder joint, particularly in youngs men. The bony abnormaliti
es encountered in patients with glenohumeral instability can be difficult t
o detect with conventional radiography, even with special views. The aim of
our study was to evaluate the bony abnormalities associated with glenohume
ral instability using CT imaging with 3-D reconstruction images. We scanned
11 patients with glenohumeral instability, one with bilateral symptoms; 10
were male, one female, and their ages ranged from 18-66 years. Contiguous
3 mm axial slices of the glenohumeral joint were taken at 2 mm intervals us
ing a Siemens Somatom CT scanner. In the 12 shoulders imaged, we identified
four main abnormalities. A humeral-head defect or Hill-Sachs deformity was
seen in 83% cases, fractures of the anterior glenoid rim in 50%, periostea
l new bone formation secondary to capsular stripping in 42%, and loose bone
fragments in 25%. Manipulation of the 3-D images enabled the abnormalities
to be well seen in all cases, giving a graphic visualization of the joint,
and only two 3-D images were needed to demonstrate all the necessary infor
mation. We feel that CT is the imaging modality most likely to show all the
bone abnormalities associated with glenohumeral instability. These bony ch
anges may lead to the correct inference of soft tissue abnormalities making
more invasive examinations such as arthrography unnecessary. Clin. Anat. 1
2:326-336, 1999. (C) 1999 Wiley-Liss, Inc.