Korean J Sports Med.  2017 Dec;35(3):162-171. 10.5763/kjsm.2017.35.3.162.

Posterior Glenoid Lesions on Magnetic Resonance Imaging in Adolescent Baseball Players

• Park KB
• Cho HL
• Jin HK
• Kim SS
• Kim JU

• KMID: 2397811
• DOI: http://doi.org/10.5763/kjsm.2017.35.3.162

Abstract

The purpose of this study is to evaluate the characteristics of posterior glenoid lesion (PGL) on magnetic resonance imaging (MRI) in adolescent baseball players. Seventy-two adolescent baseball players (mean age, 15.1 years) who underwent MRI scan for dominant shoulder pain were enrolled and the location and morphologic features of PGLs were assessed on MRI. All players were divided into three groups based on the physeal status of proximal humerus: group I, open; group II, partial closure; and group III, complete closure. Of the 72 players, posterior glenoid rim rounding (69%) and periosteal thickening (88%) were the main PGL on axial imaging. Osteochondritis dissecans (OCD) of glenoid (10%), Bennett lesion (6%), and posterior labral tear (21%) were also identified. On oblique sagittal imaging, bony PGL including OCD involves mid-portion of posterior glenoid consistent with the level of the infraspinatus muscle, but Bennett lesion was located relatively lower than PGL. Posterior glenoid rim rounding was more prevalent in younger players (group I, 86%; group II, 78%; group III, 43%; p=0.015), and posterior labral tears were in older players (group I, 0%; group II, 19%; group III, 38%, p=0.027). Factors related with prevalence of posterior glenoid rim rounding were increased body mass index (p=0.016), pitchers (p=0.024), and players with posterior shoulder tightness (p=0.023), but career length was not statistically significant (p=0.089). Decreasing the rate of posterior glenoid rim rounding with skeletal growth implies that it may be recovered through the remodeling process, and labral tears are increasing internal impingement lesion after physeal closure.

Keyword

Adolescent baseball thrower; Bennett lesion; Magnetic resonance imaging; Posterior glenoid

MeSH Terms

Adolescent*
Baseball*
Body Mass Index
Humans
Humerus
Magnetic Resonance Imaging*
Osteochondritis Dissecans
Prevalence
Shoulder
Shoulder Pain
Tears

Figure

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  Fig. 1 Classification of physeal status by contralateral anteroposterior radiographs of proximal humerus. (A) Group I: open, (B) group II: partial closure, (C) group III: complete closure.

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  Fig. 2 Typical location of bony posterior glenoid lesion on T1 weighted oblique sagittal magnetic resonance imaging and dotted lines separate each region of the posterior glenoid lesion. SSP: supraspinatus muscle, ISP: infraspinatus muscle, TM: teres minor muscle.

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  Fig. 3 Various posterior glenoid lesions on fat suppressed proton density axial magnetic resonance imaging. (A) Posterior glenoid rim rounding (arrow). (B, C) Periosteal reaction and thickening (arrows) around posterior glenoid. (D) Osteochondritis dissecans (arrow) of posterior glenoid. (E) Bennett lesion (arrow). (F) Posterior labral tear (arrow).

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  Fig. 4 Posterior glenoid lesions on fat suppressed proton density oblique sagittal magnetic resonance imaging. (A, B) Typical bony posterior glenoid lesions (arrows) made by posterior glenoid rounding and periosteal thickening show crescenteric shape of low signal intensity lesion in the region of infraspinatus muscle level. (C, D) Round low signal intensity lesion of osteochondritis dissecans of the posterior glenoid (arrows) are also located on infraspinatus muscle level, but slight superior to typical posterior glenoid lesion. (E, F) Low signal intensity Bennett lesions (arrows) are located more inferior to the posterior glenoid lesions corresponding the junction of infraspinatus and teres minor muscle and high signal intensity edema around the lesions.

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