Inspection, arthroscopy and magnetic resonance findings correlation at shoulder SLAP II lesions

Shoulder SLAP (Superior Labrum Anterior Posterior) lesions are difficult to diagnose clinically due to anatomical variations of the labrum and accompained with the other shoulder pathologies. SLAP II superior labral lesions, with an incidence of 70%, are the most common type in the clinic56,58. Some specific tests have been described to diagnose SLAP II lesions clinically and one of them is the O'Brien test (active compression test) with high sensitivity. In addition, widespread today, MRI (Magnetic Resonance Imaging) facilitates the use of the diagnosis of SLAP II lesions. MRI helps us detection of pathology and treatment planning, as well as giving information about the method of concomitant pathologies. Aim of this study is to compare the current MRI images stored by scanning, arthroscopic images determined with pathology, and clinical results of them. 334 patients with MRI and arthroscopic digital records were included the study. All patients were operated by a single surgeon and their arthroscopy images archived. Arthroscopically diagnosed, repaired 134 SLAP II patients were established working group, and 200 patients with other pathologies repaired with arthroscopy were included the control group. Preoperative clinical examination of patients, O'Brien test, MRI coronal oblique sections in the presence of a liquid under the biceps anchor, signal increase in the glenoid, leaving biceps grip site and cleavage of superior glenoid labrum findings were grouped arthroscopically SLAP II according to positive and negativity. In addition, each group of patients determined for age, gender, and operated parties. All patients were examined, sensitivity 45% and specificity 75% of O'Brien test was calculated. Positive predictive value 83%, negative predictive value 28% was found. O'Brien test results of the patients when compared with the arthroscopic views statistically significant relationship was found O'Brien test positivity with arthroscopic diagnosis of the SLAP II lesions (p=0,001). All patients examined, MRI analysis of under the biceps tendon adhesion site of fluid and / or the formation of cleavage labrum superior sensitivity 80% and specificity 70% were calculated. As a result, in 134 patients who diagnosed and treated arthroscopically for SLAP II, 89 patients (%66,4) has both O'Brien test positivity and finding of fluid under the biceps tendon adhesion site and / or the formation of cleavage labrum superior in MRI. MRI findings and the arthroscopic views of all patients were compared, arthroscopically diagnosed SLAP II patients detected on MRI in with a liquid present under the place of biceps adhesion and / or glenoid labrumda cleavage was statistically significant (p = 0.001). Key worlds: Superior labrum anteroposterior, shoulder arthroscopy, Magnetic Resonance Imaging, active compression test (O'Brien test)