Significance of Magnetic Resonance Images in Detection of Shoulder Injuries

Abstract

Introduction: The shoulder is one of the major weights bearing joint that provides not only mobility and stability during physical activity, but also balance while standing. Sport injuries are injuries caused by sports activities and may lead to severe pain and disability. Magnetic resonance imaging (MRI) is established as the leading modality for noninvasive evaluation of the sports shoulder injuries and injuries caused by other physical activities with its multi-planar capabilities and excellent soft-tissue contrast. The aim of the study: Is to investigate the accuracy of MRI in assessment of shoulders injuries. Materials and methods: This is a prospective study which includes 30 patients with shoulder pain gain during different activities from period of June 2f020 to September 2023.All patients came to department of traumatology at University clinic for Surgery “St. Naum Ohridski “– Skopje, and after physical examination were sent for conventional radiography, which was not conclusive, and after that MRI examination at the department of radiology at the same clinic was performed. In all patients magnetic resonance images (MRI) was performed at 1.5 T MR in SAG T2 weighted images, SAG proton density (PD) weighted images, COR STIR weighted images, COR T1 weighted images, AX PD weighted images. The results from MRI were evaluated and also compared with the results from arthroscopy or surgery performed later on. Results: 30 patients with shoulder trauma were included in this study, from them 20 males and 10 females, age range from 16 to 55. Depending on the cause of the injury 17 patients get shoulder injury while preforming different sport activities, mostly handball. Weight barring was cause of injury for 8 patients and 5 of them felt pain during regular physical activities and working.    Depending from the MRI results: in 15 patient Hill Sachs lesion was detected on MRI, 6 patient had Bankart lesion, 3 patients have founding of bone edema and cartilage injuries. 2 patients have impingement syndrome, 4 patients have lesion of some muscle from the rotator cuff, 3 were diagnosed with partial lesion and one with complete lesion (2 supraspinatus tendon pathology and 1 infraspinatus and 1 teres minor complete tendon pathology). With comparison of the results from MRI finding with arthroscopy or surgery findings, which were taken as a gold standard, we get the accuracy of MRI. The accuracy of MRI in detection the Hill Sachs lesion was 93.3%, in Bankart lesion 83.3%, in posttraumatic bone edema 66.67%, 50% for detection the impingement syndrome and 75% for lesion of some muscle from the rotator cuff. This study has shown total accuracy of MRI in finding shoulder trauma lesions at 83.33%. Conclusion: MRI is noninvasive diagnostic tool with high accuracy and it is the primary approach in sport shoulder injuries or injuries gain during different activities. Thus MRI is superior to the diagnostic arthroscopy and we recommend MRI as the primary diagnostic tool for the evaluation of sports shoulder trauma lesions. This study has shown total accuracy of MRI in finding the shoulder injuries at 83.33%, which makes it valuable noninvasive diagnostic tool for primary shoulder injuries.