SLAP V lesion- MR arthrography of the shoulder
Shoulder pain, difficulty on arm uplifting and limited range of movement. History of shoulder dislocation.
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- Bucket-handle tear with splitting of the anterior superior labrum is noted. The lesion is not extending across the bicipital labral complex yet the bicipital tendon shows gross thickening with intermediate T1 and T2 signal intensity.
- A linear band of increased signal intensity is seen within the anterior inferior labrum (Bankart lesion) with superior extension of the tear.
- The distal supraspinatus tendon shows mild thickening and tendinosis with increased signal intensity demonstrating intermediate T1 and T2 signal.
- The subscapularis tendon shows mild thickening with increased signal intensity.
- Intact other rotator cuff muscles and tendons.
- No evidence of Hill-Sachs fracture. No marrow signal abnormality of the examined bones.
- Mild acromio-clavicular osteoarthritis with no evidence of impingement.
The case demonstrates the superiority of the MR arthrography in detection of SLAP lesions. Bucket-handle tear of the anterior superior glenoid labrum associated with bicipital tendinosis. Associated tear of the anterior inferior labrum (Bankart lesion) with superior extension of the tear is seen and considered as SLAP V lesion. Mild subscapularis and supraspinatus tendinopathy as well as mild acromio-clavicular osteoarthritis. Superior labrum anterior cuff (SLAC) lesion is a SLAP lesion associated with partial thickness tear of the undersurface of the supraspinatus tendon with shoulder microinstability.
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