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  • Title: First-time shoulder dislocation: High prevalence of labral injury and age-related differences revealed by MR arthrography.
    Author: Antonio GE, Griffith JF, Yu AB, Yung PS, Chan KM, Ahuja AT.
    Journal: J Magn Reson Imaging; 2007 Oct; 26(4):983-91. PubMed ID: 17896393.
    Abstract:
    PURPOSE: To evaluate abnormalities and age-related differences after first-time shoulder dislocation. MATERIALS AND METHODS: MRA images of first-time dislocators were assessed for labral-ligamentous-capsular / rotator cuff abnormalities and analyzed the age-related differences (< and >/=30 years old). RESULTS: Sixty-six patients (34 <30 years old vs. 32 >/=30 years; 51 males; all anterior dislocations) were imaged. Forty-eight patients (73%) showed anteroinferior labral avulsion, consisting of: 6% (4/34 vs. 0/32) Perthes; 23% (8/34 vs. 7/32) free ALPSA (anterior labrum periosteal sleeve avulsion) lesion); 6% (1/34 vs. 3/32) adherent ALPSA; 23% (9/34 vs. 6/32) Bankart; 14% (5/34 vs. 4/32) inferiorly displaced avulsed labrum; 2% (1/34 vs. 0/32) GLAD. Extensive labral detachment (extended above 3 o'clock position) was present in 31% (11/28 vs. 4/20). There were 14% (6/34 vs. 3/32) superior labrum anterior-posterior (SLAP) lesion; 27% (1/34 vs. 17/34) rotator cuff tendon tear; 71% (25/34 vs. 22/32) Hill-Sachs defect. Young patients were more likely to have extensive labral avulsions (P = 0.054), but less likely to have rotator cuff tears (P < 0.001). CONCLUSION: A high prevalence and wide variety of labral avulsions after first-time shoulder dislocation, especially adherent ALPSA, inferiorly displaced avulsed labrum, or GLAD lesion, may influence treatment choice and outcome, suggesting a role for early MRA to assist in treatment triage.
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