Lee D. Kaplan, M.D. a * [MEDLINE LOOKUP] Patrick J. McMahon, M.D. b [MEDLINE LOOKUP] Jeffrey Towers, M.D. c [MEDLINE LOOKUP] Jay J. Irrgang, M.D. b [MEDLINE LOOKUP] Mark W. Rodosky, M.D b [MEDLINE LOOKUP]
The purpose of this study was to examine preoperative shoulder magnetic resonance imaging (MRI) and intraoperative arthroscopic findings in throwing athletes with a clinical diagnosis of internal impingement. Type of Study: Retrospective review.
A retrospective review of the surgical indications for 769 shoulder arthroscopic procedures performed from 1997 to 2000 revealed 9 throwing athletes with a diagnosis of severe internal impingement. Each had failed treatment that included a minimum of 3 months of rehabilitation. Preoperative MRIs in all 9 were read by a fellowship-trained musculoskeletal radiologist blinded to the operative findings. Findings at arthroscopy were culled from the operative reports.
On both MRI and at arthroscopy, all 9 athletes had posterosuperior labral lesions, 1 had a humeral head articular cartilage lesion, and 1 had a SLAP lesion. Additional findings on MRI included humeral head edema, subchondral cystic changes, posterosuperior glenoid sclerosis, and rotator cuff tendonopathy predominately in the infraspinatus. At arthroscopy, there were additional findings of articular-sided partial rotator cuff tears not shown on MRI.
Both MRI and arthroscopic findings described labral and humeral head articular cartilage lesions. These findings may be indicative of internal impingement in throwing athletes.
The Journal of Arthroscopic & Relate Surgery. September 2004 Volume 20 Number 7.