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CT and MR Arthrography of the Normal and Pathologic Anterosuperior Labrum and Labral-Bicipital Complex¹

¹ From the Departments of Radiology (M.D.M., M.S., M.O.), Experimental Anatomy (F.V.R.), and Orthopedic Surgery (F.H.), Vrije Universiteit Brussel, Laerbeeklaan 101, 1090 Jette, Belgium; the Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, NC (L.L.); the Department of Radiology, University of Michigan Medical Center, Ann Arbor (J.J.); and the Department of Radiology, Kyung Hee University Hospital, Seoul, South Korea (K.N.R.). Recipient of a Certificate of Merit award for a scientific exhibit at the 1998 RSNA scientific assembly. Received January 21, 2000; revision requested February 23 and received April 6; accepted April 19. Address correspondence to M.D.M. (e-mail: midema@village.uunet.be).

Interpretation of computed tomographic and magnetic resonance arthrograms of the shoulder is complicated by normal variants of the labrum and glenohumeral ligaments. A superior sublabral recess is located at the 12 o'clock position and represents a normal recess between the superior labrum and the cartilage of the glenoid cavity. A sublabral foramen is located at the 2 o'clock position and represents localized detachment of the labrum from the glenoid rim. Buford complex is characterized by absence of the anterosuperior labrum and cordlike thickening of the middle glenohumeral ligament. Imaging features of damage to the anterior labrum include absence or detachment of the labrum and an irregular frayed appearance. Superior labrum anterior-to-posterior (SLAP) lesions are classified as type I (tear confined to the superior labrum), type II (labrum and biceps tendon detached from the superior glenoid), type III (bucket handle tear of the superior labrum), or type IV (bucket handle tear of the superior labrum with lateral extension into the biceps tendon). Increased distance between the labrum and the glenoid, an irregular appearance of the labral margin, or lateral extension of the separation may suggest a SLAP lesion rather than a normal anatomic variant. However, differentiation between normal variants and pathologic conditions and between various types of SLAP lesions remains difficult.

Index Terms: Shoulder, 414.13 • Shoulder, anatomy, 414.92 • Shoulder, arthrography, 414.122 • Shoulder, CT, 414.1211 • Shoulder, injuries, 414.481 • Shoulder, MR, 414.1214

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