J Korean Soc Radiol.  2016 Mar;74(3):177-184. 10.3348/jksr.2016.74.3.177.

Correlation of the Rotator Interval on Direct CT Arthrography in Shoulder Instability Patients with External Rotation Stress Radiographs

• Jung YS
• Choi HS
• Choi JA

• KMID: 2155277
• DOI: http://doi.org/10.3348/jksr.2016.74.3.177

Abstract

PURPOSE
To correlate rotator interval dimensions on direct CT arthrography (CTA) with external rotation shoulder stress radiographs in patients with shoulder instability.
MATERIALS AND METHODS
One hundred and twenty-three shoulders of 115 patients with shoulder instability that underwent direct CTA and shoulder stress radiographs in neutral position and external rotation were enrolled. Axial, oblique coronal, oblique sagittal CT images were obtained after intra-articular contrast injection. Width and depth of rotator interval on sagittal CTA images were evaluated and acromiohumeral (AH) distance on neutral and external rotation stress radiographs were measured. CTA measurements were compared with AH on stress radiographs according to the group with or without "external rotational instability".
RESULTS
Out of 123 shoulders, 79 with external rotation instability showed increased or unchanged AH distance on external rotation compared with neutral position. Width of rotator interval was 2.43 +/- 0.31 cm and depth was 0.87 +/- 0.2 cm. Forty-four shoulders without external rotation instability showed decreased AH distance on external rotation compared with neutral position. Width of rotator interval was 2.02 +/- 0.45 cm and depth was 0.75 +/- 0.2 cm. Width and depth of rotator interval were significantly greater in the external rotation instability group.
CONCLUSION
Width and depth of rotator interval on CTA were significantly correlated with AH distance on external rotation stress radiographs.

MeSH Terms

Arthrography*
Humans
Radiography
Rotator Cuff
Shoulder*

Figure

• 

  Fig. 1 A case of "external rotation instability positive". A. The stress radiograph in neutral position is obtained in a 27-year-old man with right shoulder instability. The acromiohumeral (AH) distance (double-headed arrow) is 1.93 cm. B. The AH distance on the stress radiograph in external rotation position (double-headed arrow) is 2.51 cm. There is increased AH distance compared to neutral stress radiograph. C. An oblique sagittal CT arthrographic image shows the rotator interval (RI) dimensions. The width of the RI (long arrow) is 2.29 cm and the depth (short arrow) is 0.88 cm. D. RI widening (arrows) is seen along with anteroinferior labral tear (arrowheads) at arthroscopy, so RI closure is performed.

• 

  Fig. 2 A case of "external rotation instability negative". A. The stress radiograph in neutral position is obtained in 23-year-old man with right shoulder instability. The acromiohumeral (AH) distance (arrow) is 1.92 cm. B. The AH distance on the stress radiograph (arrow) in external rotation position is 1.66 cm. There is decreased AH distance compared to neutral stress radiograph. C. An oblique sagittal CT arthrographic image shows the rotator interval (RI) dimensions. The width of the RI (long arrow) is 1.88 cm and the depth (short arrow) is 0.54 cm.

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