Loss of the sclerotic line of the glenoid on anteroposterior radiographs of the shoulder: A diagnostic sign for an osseous defect of the anterior glenoid rim

• Published in: Journal of shoulder and elbow surgery Vol. 19; no. 1; pp. 151 - 156
• Main Authors: Jankauskas, Linas, MD, Rüdiger, Hannes A., MD, Pfirrmann, Christian W.A., MD, Jost, Bernhard, MD, Gerber, Christian, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 2010; Elsevier
• Subjects: Adolescent; Adult; Aged; Bankart lesion; Biological and medical sciences; Case-Control Studies; Diseases of the osteoarticular system; Female; glenoid rim; Humans; instability; Joint Instability - diagnostic imaging; Joint Instability - etiology; Joint Instability - pathology; Male; Medical sciences; Middle Aged; Observer Variation; Orthopedics; Probability; Reference Values; Retrospective Studies; Sensitivity and Specificity; Shoulder; Shoulder Dislocation - diagnostic imaging; Shoulder Dislocation - etiology; Shoulder Dislocation - pathology; Shoulder Joint - diagnostic imaging; Shoulder Joint - pathology; Tomography, X-Ray Computed - methods; x-ray; Young Adult; glenoid rim; Bankart lesion; x-ray; Shoulder; instability; Radiography; Glenoid cavity; Radiodiagnosis; Diseases of the osteoarticular system; Rheumatology; Exploration; Bone defect; Diagnosis
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2009.04.013

Background The integrity of the glenoid defines the surgical treatment in anterior shoulder instabilities. The reliability of plain radiographs to detect anterior glenoid rim deficiencies was determined. Materials and methods The anterior sclerotic glenoid line (SGL) was assessed on anteroposterior radiographs of 86 shoulders (34 anterior instabilities, 15 posterior instabilities, 37 stable) and compared with computed tomography (CT) scans (gold standard). A loss of the SGL (LSGL) was defined as a positive LSGL sign. Results On CT scans, 25 of 34 shoulders (74%) with anterior instabilities showed a defect of the anterior glenoid rim. No defects were found in shoulders without anterior instabilities. LSGL correctly predicted an anterior glenoid rim lesion in 16 (examiner A) or 14 (examiner B) of the 25 anterior instabilities (sensitivity, 64% and 56%), without a false-positive diagnosis (specificity, 100%). Conclusion The LSGL on anteroposterior radiographs is a moderately sensitive but highly specific finding for anterior glenoid rim defects. Level of evidence Level 4; Diagnostic study, case control study.