Normal Glenoid Ossification in Pediatric and Adolescent Shoulders Mimics Bankart Lesions: A Magnetic Resonance Imaging-Based Study.

Autor:	Sidharthan S; Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA., Greditzer HG 4th; Division of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA., Heath MR; Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA., Suryavanshi JR; Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA., Green DW; Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA., Fabricant PD; Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA. Electronic address: fabricantp@hss.edu.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2020 Feb; Vol. 36 (2), pp. 336-344. Date of Electronic Publication: 2019 Dec 31.
DOI:	10.1016/j.arthro.2019.08.011
Abstrakt:	Purpose: The purpose of this descriptive study was to define patterns of ossification and fusion of growth centers around the pediatric and adolescent glenoid as a function of age using 3-dimensional, frequency-selective, fat-suppressed spoiled gradient recalled echo magnetic resonance (MR) imaging sequences, with a particular focus on the anterior glenoid rim because of its clinical relevance as a potential confounder of glenohumeral instability. Methods: Picture Archiving and Communication System records at an urban academic tertiary care orthopaedic facility from October 2005 to December 2018 were queried for shoulder MRI in patients aged 9 to 17 years. Patients were excluded if they had any diagnoses that could alter glenoid development. All images were independently evaluated by a musculoskeletal fellowship-trained radiologist. Secondary ossification centers were characterized as cartilage anlage, ossified, or fused at 3 anatomic sites: the anterior glenoid rim, coracoid, and superior glenoid rim. Results: A total of 250 MR examinations (143 males, 107 females) were assessed in this study. The glenoid develops in a predictably sequential manner with ossification at the anterior glenoid rim lagging behind the coracoid and superior glenoid rim. The earliest age of anterior glenoid rim ossification was 11 years for both males (range 11-17) and females (range 11-12). Anterior glenoid rim ossification peaked at age 16 among males (34.8%, 8/23) and age 11 among females (27.3%, 3/11). Conclusions: Glenoid ossification and fusion progress in a predictable and chronological manner. This pattern should be used as a guideline when interpreting pediatric shoulder MRI examinations. In particular, an anterior glenoid ossification center should not be confused with an anterior glenoid injury (e.g., Bankart lesion), particularly in males 11 to 17 years old and females 11 to 12 years old. Level of Evidence: IV (case series). (Copyright © 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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