Magnetic resonance evaluation of the labral capsular ligamentous complex: a pictorial review.

Overview

Magnetic resonance imaging of the shoulder is a common imaging test, and in the course of routine evaluation it can provide accurate information regarding the labral capsular ligamentous complex (LCLC). Common patterns of labral injury include fraying, flap tears and labral distraction, which can be readily identified on both coronal and axial planes by paying attention to signal and morphological characteristics. Capsular and ligamentous pathology may be subtle, but is recognizable using a high-resolution technique that has differential contrast between native intra-articular fluid and the adjacent labrum and capsular restraints. Common patterns of capsular injury include a thickened, hyperintense capsule, sometimes with disruption and retraction. The inferior glenohumeral ligament is the primary stabilizer of the shoulder joint, and although failure of this structure is uncommon, the injury is easily identified. Shoulder instability is a common presentation, the diagnosis of which is dependent upon recognizing various injury patterns including Bankart lesions, reverse Bankart lesions, anterior labroligamentous periosteal sleeve avulsion (ALPSA) and failure of the inferior glenohumeral ligament.