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Review
. 2015 Jul-Aug;48(4):242-8.
doi: 10.1590/0100-3984.2013.0006.

Artifacts and pitfalls in shoulder magnetic resonance imaging

Gustavo Felix Marcon  1 , Tulio Augusto Alves Macedo  2
Affiliations
Review

Artifacts and pitfalls in shoulder magnetic resonance imaging

Gustavo Felix Marcon et al. Radiol Bras. 2015 Jul-Aug.

Abstract
in English, Portuguese

Magnetic resonance imaging has revolutionized the diagnosis of shoulder lesions, in many cases becoming the method of choice. However, anatomical variations, artifacts and the particularity of the method may be a source of pitfalls, especially for less experienced radiologists. In order to avoid false-positive and false-negative results, the authors carried out a compilation of imaging findings that may simulate injury. It is the authors' intention to provide a useful, consistent and comprehensive reference for both beginner residents and skilled radiologists who work with musculoskeletal magnetic resonance imaging, allowing for them to develop more precise reports and helping them to avoid making mistakes.

A ressonância magnética revolucionou o diagnóstico de lesões do ombro, tornando-se, em muitos casos, o método de escolha. No entanto, as variações anatômicas, artefatos e particularidade do método podem ser fonte de armadilhas, especialmente para radiologistas menos experientes. Para evitar resultados falso-positivos e falso-negativos, foi realizada uma compilação de achados de imagem que podem simular lesões. Pretendemos ser uma referência útil, consistente e abrangente para os residentes iniciantes e radiologistas qualificados que trabalham com ressonância magnética musculoesquelética, a fim de desenvolver relatórios mais precisos e ajudá-los a evitar erros.

Keywords: Artifacts; Magnetic resonance imaging; Musculoskeletal; Pitfalls; Shoulder.

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Figures

Figure 1
Figure 1
Biceps vincula (mesotendon). The biceps tendon obtains its blood supply from a mesotendon (arrow), also called vincula tendinum.
Figure 2
Figure 2
Vessels adjacent to the long head of the biceps tendon (arrows).
Figure 3
Figure 3
Bifid biceps tendon (arrow).
Figure 4
Figure 4
Frequently, in the area of the insertion, one can hardly determine where the supraspinatus tendon ends and where the infraspinatus tendon starts.
Figure 5
Figure 5
Magic angle and rotator cuff. Increased signal in the supraspinatus tendon at short TE sequence.
Figure 6
Figure 6
Magic angle and rotator cuff. Coronal PD and T2-weighted images of the supraspinatus insertion. At left, increased signal on the short TE sequence (arrow), which is not seen on the long TE sequence at right (arrow).
Figure 7
Figure 7
A small sulcus between the osseous insertion of the supraspinatus and the articular cartilage (arrow) is a normal finding.
Figure 8
Figure 8
Thickened MGHL (arrow) and absent anterosuperior labrum (Buford complex).
Figure 9
Figure 9
The sublabral foramen (arrows) is an anatomic variation and sometimes it may be not easily differentiated from labral tear.
Figure 10
Figure 10
Coronal MR arthrography T1-weighted sequence showing a normal sulcus in the region of the biceps-labral complex (arrow), which is typically parallel to the glenoid (A). In SLAP tears, the signal alteration extends towards the substance of the superior labrum (B).
Figure 11
Figure 11
Subscapular recess (A) versus subcoracoid bursa (B). The subescapular recess communicates with the glenohumeral joint (short arrow). The subcoracoid bursa is located anteriorly to the subscapular tendon and inferiorly to the coracoid process, but does not communicate with the joint cavity. Coracoid process (arrowheads).
Figure 12
Figure 12
Exaggerated internal rotation on the image A, simulating subscapularis tendon thickening (short arrow). Certainly, the tendon is normal (long arrow) with external rotation (B).
Figure 13
Figure 13
The figures represent each acromion type.
Figure 14
Figure 14
Acromial ossification centers. Basiacromion (BA), meta-acromion (MTA), mesoacromion (MSA) and preacromion (PA).
Figure 15
Figure 15
Os acromiale.
Figure 16
Figure 16
Normal groove in the posterior aspect of the humeral head (A). Hill- Sachs defects are visible on the uppermost axial sections (B).
Figure 17
Figure 17
Tubercle of Ossaki. Area of focal subchondral bone thickening with thinned overlying cartilage (arrows).
Figure 18
Figure 18
Normal bone marrow striations.
See this image and copyright information in PMC

References

    1. Pal GP, Bhatt RH, Patel VS. Relationship between the tendon of the long head of biceps brachii and the glenoidal labrum in humans. Anat Rec. 1991;229:278–280. - PubMed
    1. Vangsness CT, Jr, Jorgenson SS, Watson T, et al. The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders. J Bone Joint Surg Br. 1994;76:951–954. - PubMed
    1. Fitzpatrick D, Walz DM. Shoulder MR imaging normal variants and imaging artifacts. Magn Reson Imaging Clin N Am. 2010;18:615–632. - PubMed
    1. MacDonald PB. Congenital anomaly of the biceps tendon and anatomy within the shoulder joint. Arthroscopy. 1998;14:741–742. - PubMed
    1. Yeh L, Pedowitz R, Kwak S, et al. Intracapsular origin of the long head of the biceps tendon. Skeletal Radiol. 1999;28:178–181. - PubMed

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