Mild anteroinferior capsular thickening and edema, but no anteroinferior labral tear
Oddly, they ordered this without and with iv contrast….had anyone asked me, I would have said it wasn’t indicated
I was surprised by the degree of circumferential capsular enhancement
The SLAP lesion enhances
I have to say that, years ago, I tried and was repeatedly disappointed and annoyed with the inconvenience of "indirect MRI arthrography" with exercise and delay after iv contrast
These images are post contrast with no post injection delay.
I have seen labral enhancement in the context of adhesive capsulitis, but this seems to cut both ways, as the dramatic diffuse capsular enhancement would suggest adhesive capsulitis in an older patient without SLAP lesion and, ideally, limited range of motion.
Unfortunately, I was given absolutely no history, so I didn’t know why they ordered the exam with contrast.
Now I’m wondering how much pathology I have missed without contrast.
Thoughts?
Hilary