Semin Musculoskelet Radiol 2004; 8(1): 29-40
DOI: 10.1055/s-2004-823013
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Shoulder Imaging in Athletes

Phillip F. J. Tirman1 , Eric D. Smith1 , David W. Stoller1 , Russell C. Fritz1
  • 1National Orthopedic Imaging Associates, Greenbrae, CA
Further Information

Publication History

Publication Date:
13 April 2004 (online)

Shoulder pain and injuries are common in athletes. Overhead athletes, in particular, place great demands on the shoulder and supporting structures. Magnetic resonance (MR) imaging is well suited to evaluation of the osseous structures and soft tissues of the shoulder and plays an important role in evaluation of shoulder pain in athletes. Primary extrinsic impingement is well evaluated on MR imaging as are the less common posterior superior glenoid impingement and subcoracoid impingement. Rotator cuff tendinosis as well as partial- and full-thickness tears are frequently encountered in the athletic shoulder. The biceps tendon and rotator interval capsular structures are important sources of shoulder pain. Glenohumeral instability that results from a traumatic event or atraumatic multidirectional recurrent instability is assessed. The biceps labral complex is a source of considerable anatomic variability and pathology.

REFERENCES

  • 1 Bigliani L U, Ticker J B, Flatow E L, Soslowsky L J, Mow V C. The relationship of acromial architectute to rotator cuff disease.  Clin Sports Med. 1991;  10 823-838
  • 2 Banas M P, Miller R J, Totterman S. Relationship between the lateral acromial angle and rotator cuff disease.  J Shoulder Elbow Surg. 1995;  4 454-461
  • 3 Edelson J G, Zuckerman J, Hershkovitz I. Os acromiale: anatomy and surgical implications.  J Bone Joint Surg Br. 1993;  75 551-555
  • 4 Dines D, Warren R F, Inglis A E et al.. The coracoid impingement syndrome.  J Bone Joint Surg Br. 1990;  72 314-316
  • 5 Jobe F W, Kvitne R S, Giangarra C E. Shoulder pain in the overhand or throwing athlete: the relationship of anterior instability and rotator cuff impingement.  Orthop Rev. 1989;  18 963-975
  • 6 Walch G, Liotard J P, Boileau P, Noel E. Postero-superior glenoid impingement. Another impingement of the shoulder [in French].  J Radiol. 1993;  74 47-50
  • 7 Kannus P, Jozsa L. Histopathological changes preceding spontaneous rupture of a tendon: a controlled study of 891 patients.  J Bone Joint Surg Am. 1991;  73 1507-1525
  • 8 Hodler J, Kursunoglu-Brahme S, Snyder S J et al.. Rotator cuff disease: assessment with MR arthrography versus standard MR imaging in 36 patients with arthroscopic confirmation.  Radiology. 1992;  182 431-436
  • 9 Jobe C M. Evidence for a superior glenoid impingement: expanded spectrum.  Arthroscopy. 1995;  11 530-536
  • 10 Deutsch A, Altchek D W, Veltri D M et al.. Traumatic tears of the subscapularis tendon: clinical diagnosis, magnetic resonance imaging findings, and operative treatment.  Am J Sports Med. 1997;  25 13-22
  • 11 Ho C. MR imaging of the thrower's shoulder.  Mag Reson Imaging Clin N Am. 1999;  7 39-47
  • 12 Walch G, Nove-Josserand L, Boileau P, Levigne C. Subluxations and dislocations of the tendon of the long head of the biceps.  J Shoulder Elbow Surg. 1998;  7 100-108
  • 13 Patten R M. Tears of the anterior portion of the rotator cuff (the subscapularis tendon): MR imaging findings.  AJR Am J Roentgenol. 1994;  162 351-354
  • 14 Silliman J, Hawkins R. Classification and physical diagnosis of instability of the shoulder.  Clin Sports Med. 1991;  10 693-705
  • 15 Crues J V, Ryu R K. The shoulder. In: Stark D, Bradley WG Magnetic Resonance Imaging. St Louis; Mosby 1991: 2424-2458
  • 16 Tirman P F, Feller J F, Palmer W et al.. The Buford complex-a variation of normal shoulder anatomy: MR arthrographic imaging features.  AMJ Am J Roentgenol. 1996;  166 869-873
  • 17 Bankart A S, Cantab M C. Recurrent or habitual dislocation of the shoulder-joint.  Clin Orthop. 1993;  291 3-6
  • 18 Neviaser T J. The anterior labroligamentous periosteal sleeve avulsion lesion: a cause of anterior instability of the shoulder.  Arthroscopy. 1993;  9 17-21
  • 19 Neviaser R J, Neviaser T J, Neviaser J S. Anterior dislocation of the shoulder and rotator cuff rupture.  Clin Orthop. 1993;  291 103-106
  • 20 Tirman P. Glenohumeral instability. In: Steinbach L, Tirman P, Peterfy C, Feller J Shoulder Magnetic Resonance Imaging. Baltimore, MD; Lippincott 1998: 135-167
  • 21 Snyder S J, Karzel R P, Del Pizzo W et al.. SLAP lesions of the shoulder.  Arthroscopy. 1990;  6 274-279
  • 22 Nottage W M. Controversial topics in shoulder arthroscopy-microinstability.  Arthroscopy. 2002;  18 65-67
  • 23 Schickendantz M S, Ho C P, Keppler L, Shaw B D. MR imaging of the thrower's shoulder.  Mag Reson Imaging N Am. 1999;  7 39-47

Phillip F J TirmanM.D. 

National Orthopedic Imaging Associates, 1260 South Eliseo Drive

Greenbrae, CA 94904

Email: ptirman@immixmgt.com

    >