Skip to Content

Orthopaedic Sports Medicine Experts Awarded Clinical Research Excellence Award

January 31, 2025

Several UPMC orthopaedic experts, including Ting Cong, MD; Shaquille Charles, MD, MSc; Matthew Como, MD; Nicholas Drain, MD; Jonathan D. Hughes, MD; Bryson Lesniak, MD; and Albert Lin, MD, were recently awarded the 2024 Arthroscopy Journal Award for Excellence in Clinical Research for their article, “Magnetic Resonance Arthrogram Outperforms Standard Magnetic Resonance Imaging 2 Weeks After First Shoulder Dislocation for Labral Tear Diagnosis.”

The purpose of this study was to determine the comparative accuracy and precision of conventional magnetic resonance imaging (MRI) versus magnetic resonance (MR) arthrogram in measuring labral tear size as a function of time from an acute shoulder dislocation.

In this study, the team retrospectively evaluated consecutive patients who underwent primary arthroscopic stabilization between 2012 and 2021 in a single academic center. MRI or MR arthrogram labral tear size were measured against intraoperative labral tear size as standard comparison. Three musculoskeletal radiologists independently interpreted tear extent using a novel clock-face convention in a blinded fashion. Accuracy and precision of MR labral tear measurements were defined based on location and size of the tear, respectively. Accuracy and precision were compared between MRI and MR arthrogram as a function of time from dislocation.

In total, 32 MRIs and 65 MR arthrograms (total n = 97) were assessed. Statistical analysis demonstrated that intraoperative tear size, early imaging, and arthrogram status were associated with increased MR accuracy and precision (P < .05). Ordering surgeons preferred arthrogram for delayed imaging (P = .018). For routine MRI, error in tear size estimation accuracy increased by 3.4° per day and error in precision increased by 2.3° per day (P < .001) from the day of injury. MR arthrogram, however, was not temporally influenced. Significant loss of accuracy and precision of MRI compared with MR arthrogram occurred beyond 2 weeks after an acute shoulder dislocation.

Compared with MR arthrogram, conventional MRI demonstrates time-dependent loss of accuracy and precision in determining shoulder labral tear extent after dislocation, with statistical divergence occurring at 2 weeks. Expeditious imaging using non-contrast MRI maintains high accuracy and precision, possibly due to improved tissue contrast resultant from the presence of joint fluid following acute dislocation.

Read more about this study on PubMed.

Other study authors include:

  • Carol Andrews, MD
  • Andrew Cordle, MD
  • Sophie Darwiche, MD
  • Rajiv P. Reddy, MD

Collaborators not affiliated with the University of Pittsburgh:

Justin J. Greiner, MD

              University of Nebraska Medical Center