Advertisement

Magnetic Resonance Imaging Correlates With Computed Tomography for Glenoid Version Calculation Despite Lack of Visibility of Medial Scapula

      Purpose

      To assess the accuracy of measuring glenoid version on magnetic resonance imaging (MRI) in the presence of varying amounts of the medial scapula body as compared with the gold standard of glenoid version measured on computed tomography (CT) imaging, including the entire scapula in a cohort of young patients with shoulder instability and without glenohumeral arthritis.

      Methods

      A retrospective review was performed on instability patients with preoperative MRI and CT imaging. Measurements of available scapular width and glenoid version were performed using the Cobb angle method to measure the angle between the plane of the glenoid fossa to Friedman's line on axial images. Intra- and interrater reliability analysis was performed using intraclass correlation coefficients to assess agreement between MRI and CT measurements. Paired t tests were used to compare measurement differences between MRI and CT.

      Results

      Thirty-two patients with both MRI and CT scans were assessed. Intra- and inter-rater assessment revealed strong agreement for scapular width measurement. For glenoid version measurement, intra-rater agreement was excellent and inter-rater agreement was moderate on CT and good on MRI. The mean available scapular body width was 24.7 mm longer on CT as compared with MRI (95% confidence interval 17.5-31.9, P < .0001; 109.8 ± 8.2 mm vs 85.1 ± 16.9 mm, respectively), with MRI having an average of 78.2% (±17.6%) of the CT scapular width shown on CT. No significant difference in glenoid version was found between MRI and CT (95% confidence interval −0.87 to 1.75, P = .499; MRI −2.57° vs CT −2.13°).

      Conclusion

      MRI provided significantly shorter available scapular widths when compared with CT imaging in a cohort of patients with glenohumeral instability and without arthritis. However, this failed to produce a significant difference of ≥5° in measured glenoid version compared with CT measurements when 75% (8 cm) of the scapular width was present on MRI. Measuring glenoid version on MRI does not appear to be significantly affected when the entirety of the medial border of the scapula is not included in the imaging field.

      Level of Evidence

      Level III; study of diagnostic test.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Churchill R.S.
        • Brems J.J.
        • Kotschi H.
        Glenoid size, inclination, and version: An anatomic study.
        J Shoulder Elbow Surg. 2001; 10: 327-332
        • Saha A.K.
        Dynamic stability of the glenohumeral joint.
        Acta Orthop Scand. 1971; 42: 491-505
        • Friedman R.J.
        • Hawthorne K.B.
        • Genez B.M.
        The use of computerized tomography in the measurement of glenoid version.
        J Bone Joint Surg Am. 1992; 74: 1032-1037
        • Nyffeler R.W.
        • Jost B.
        • Pfirrmann C.W.
        • Gerber C.
        Measurement of glenoid version: C radiographs versus computed tomography scans.
        J Shoulder Elbow Surg. 2003; 12: 493-496
        • Lowe J.T.
        • Testa E.J.
        • Li X.
        • Miller S.
        • DeAngelis J.P.
        • Jawa A.
        Magnetic resonance imaging is comparable to computed tomography for determination of glenoid version but does not accurately distinguish between Walch B2 and C classifications.
        J Shoulder Elbow Surg. 2017; 26: 669-673
        • Parada S.A.
        • Eichinger J.K.
        • Dumont G.D.
        • Burton L.E.
        Comparison of glenoid version and posterior humeral subluxation in patients with and without posterior shoulder instability.
        Arthroscopy. 2016; 33: 254-260
        • Walch G.
        • Badet R.
        • Boulahia A.
        • Khoury A.
        Morphologic study of the glenoid in primary glenohumeral osteoarthritis.
        J Arthroplasty. 1999; 14: 756-760
        • Matsumura N.
        • Ogawa K.
        • Ikegami H.
        • Collin P.
        • Walch G.
        • Toyama Y.
        Computed tomography measurement of glenoid vault version as an alternative measuring method for glenoid version.
        J Orthop Surg Res. 2014; 9: 17
        • Sears B.W.
        • Johnston P.S.
        • Ramsey M.L.
        • Williams G.R.
        Glenoid bone loss in primary total shoulder arthroplasty: Evaluation and management.
        J Am Acad Orthop Surg. 2012; 20: 604-613
        • Raymond A.C.
        • McCann P.A.
        • Sarangi P.P.
        Magnetic resonance scanning vs axillary radiography in the assessment of glenoid version for osteoarthritis.
        J Shoulder Elbow Surg. 2013; 22: 1078-1083
        • Harper K.W.
        • Helms C.A.
        • Haystead C.M.
        • Higgins L.D.
        Glenoid dysplasia: Incidence and association with posterior labral tears as evaluated on MRI.
        AJR Am J Roentgenol. 2005; 184: 984-988
        • Galvin J.W.
        • Parada S.A.
        • Li X.
        • Eichinger J.K.
        Critical findings on magnetic resonance arthrograms in posterior shoulder instability compared with an age-matched controlled cohort.
        Am J Sports Med. 2016; 44: 3222-3229
        • Chalmers P.N.
        • Salazar D.
        • Chamberlain A.
        • Keener J.D.
        Radiographic characterization of the B2 glenoid: Is inclusion of the entirety of the scapula necessary?.
        J Shoulder Elbow Surg. 2017; 26: 855-860
        • Gross D.J.
        • Golijanin P.
        • Dumont G.D.
        • Parada S.A.
        The effect of sagittal rotation of the glenoid on axial glenoid width and glenoid version in computed tomography scan imaging.
        J Shoulder Elbow Surg. 2015; 25: 61-68
        • Hoenecke Jr., H.R.
        • Hermida J.C.
        • Flores-Hernandez C.
        • D'Lima D.D.
        Accuracy of CT-based measurements of glenoid version for total shoulder arthroplasty.
        J Shoulder Elbow Surg. 2010; 19: 166-171
        • Boileau P.
        • Cheval D.
        • Gauci M.O.
        • Holzer N.
        • Chaoui J.
        • Walch G.
        Automated three-dimensional measurement of glenoid version and inclination in arthritic shoulders.
        J Bone Joint Surg Am. 2018; 100: 57-65
        • Aygun U.
        • Duran T.
        • Oktay O.
        • Sahin H.
        • Calik Y.
        Comparison of magnetic resonance imaging and computed tomography scans of the glenoid version in anterior dislocation of the shoulder.
        Orthopedics. 2017; 40: e687-e692
        • Eichinger J.K.
        • Galvin J.W.
        • Grassbaugh J.A.
        • Parada S.A.
        • Li X.
        Glenoid dysplasia: Pathophysiology, diagnosis, and management.
        J Bone Joint Surg Am. 2016; 98: 958-968
        • Cunningham G.
        • Freebody J.
        • Smith M.M.
        • et al.
        Comparative analysis of 2 glenoid version measurement methods in variable axial slices on 3-dimensionally reconstructed computed tomography scans.
        J Shoulder Elbow Surg. 2018; 27: 1809-1815