Patient History

A 27 year old patient suffered from chronic anterior dislocation of the shoulder without an acute injury. MR arthrography of the shoulder was performed after intraarticular injection of Gadolinium-containing contrast medium.

Image Findings

The MR arthrography showed the following findings:

T1-weighted fat-suppressed
coronal oblique shoulder
MR arthrogram.

The superior labrum is completely
separated from the adjacent glenoid
with no attachment identified.
High-signal contrast fills
the space between the glenoid
and the detached labrum.

T1-weighted fat-suppressed
sagittal oblique shoulder
MR arthrogram.

The separation between the
labrum and glenoid is filled
with contrast.

Flash T1 fat-suppressed
axial shoulder MR arthrogram.

The contrast between the
detached labrum and glenoid
is seen.

Results and Discussion

The images show a tear involving the superior labrum, a so called SLAP lesion (superior labrum tear propagating anterior and posterior to the biceps anchor). SLAP lesions are usually classified into four types that can be distinguished by modern MR arthrography. This case shows a type II lesion with detachment of the superior labrum from the glenoid affecting the biceps tendon. Differences in treatment are based on whether or not there is involvement of the biceps anchor. MR images are able to assess the integrity of the biceps tendon.