Superior sublabral sulcus
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View Henry Knipe's current disclosuresAt the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures- Sublabral sulcus
- Superior sublabral recess
- Sublabral recess
A superior sublabral sulcus or superior sublabral recess is a small synovial lined gap or detachment between the labral free edge and the cartilage, forming a normal glenoid labral variant 1. It can be associated with a sublabral foramen.
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Gross anatomy
The superior labral sulcus or recess is a small groove covered by synovium 2 caused by a loose attachment of the superior labrum to the glenoid rim. It is most often located in the anterior part of the superior labrum but can be also found more centrally 2 at the proximal attachment of the long head biceps tendon to the glenoid labrum.
The sublabral recess can feature different depths ranging from <2 mm to >5 mm 2,3.
Radiographic features
MRI
A sublabral recess is best detected on coronal oblique oriented fat-saturated T1 weighted images on MR arthrography 2 or in patients with joint effusion 1.
Typical imaging features include the following 1,4:
anterior location only extending to the posterior insertion point of the biceps tendon origin
smooth regular contour
medial orientation paralleling the glenoid cartilage underneath
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Clinical importance
A superior sublabral sulcus is a frequent finding on MRI and can be found in more than 70% of cases 2,3. It features a similar appearance and needs to be differentiated from sublabral foramen and from type II SLAP lesion 5. The latter is usually characterized by irregular contours that can extend posteriorly to the biceps tendon anchor 2 or laterally into the substance of the glenoid labrum 1.
References
- 1. Dunham K, Bencardino J, Rokito A. Anatomic Variants and Pitfalls of the Labrum, Glenoid Cartilage, and Glenohumeral Ligaments. Magn Reson Imaging Clin N Am. 2012;20(2):213-28, x. doi:10.1016/j.mric.2012.01.014 - Pubmed
- 2. Kreitner K, Botchen K, Rude J, Bittinger F, Krummenauer F, Thelen M. Superior Labrum and Labral-Bicipital Complex: MR Imaging with Pathologic-Anatomic and Histologic Correlation. AJR Am J Roentgenol. 1998;170(3):599-605. doi:10.2214/ajr.170.3.9490937 - Pubmed
- 3. Smith D, Chopp T, Aufdemorte T, Witkowski E, Jones R. Sublabral Recess of the Superior Glenoid Labrum: Study of Cadavers with Conventional Nonenhanced MR Imaging, MR Arthrography, Anatomic Dissection, and Limited Histologic Examination. Radiology. 1996;201(1):251-6. doi:10.1148/radiology.201.1.8816553 - Pubmed
- 4. Tuite M & Orwin J. Anterosuperior Labral Variants of the Shoulder: Appearance on Gradient-Recalled-Echo and Fast Spin-Echo MR Images. Radiology. 1996;199(2):537-40. doi:10.1148/radiology.199.2.8668808 - Pubmed
- 5. Jin W, Ryu K, Kwon S, Rhee Y, Yang D. MR Arthrography in the Differential Diagnosis of Type II Superior Labral Anteroposterior Lesion and Sublabral Recess. AJR Am J Roentgenol. 2006;187(4):887-93. doi:10.2214/ajr.05.0955 - Pubmed
- 6. De Maeseneer M, Van Roy F, Lenchik L et-al. CT and MR arthrography of the normal and pathologic anterosuperior labrum and labral-bicipital complex. Radiographics. 2000;20 Spec No (suppl 1): S67-81. Radiographics (full text) - Pubmed citation
- 7. Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins. (2011) ISBN:1609139437. Read it at Google Books - Find it at Amazon
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