MRI scans and axillary x-rays in assessing glenoid version in osteoarthritis

Magnetic resonance scanning vs axillary radiography in the assessment of glenoid version for osteoarthritis.

The authors suggest that correction of glenoid retroversion through anterior eccentric reaming, before glenoid component implantation, is performed to restore normal joint biomechanics and that accurate preoperative assessment is required to ascertain the degree of retroversion and calculate the degree of reaming. We are not sure that either of these statements have been proven in clinical practice.

The authors compared magnetic resonance imaging and axillary radiographs for the assessment of glenoid version in glenohumeral osteoarthritis in 48 primary osteoarthritic shoulders.

The mean glenoid version measured was -14.3° on MRI and -21.6° on axillary views (mean difference, -7.36°; P < .001). Intraobserver and interobserver reliability coefficients were 0.96 and 0.9, respectively, for MRI and 0.8 and 0.71, respectively, for axillary views. Glenoid retroversion was greater in 73% of the axillary views.

It is unclear to us that a 7 degree difference is either clinically relevant or worth the incremental cost of an MRI. In our practice a standardized axillary view has proven reliable for the determination of glenoid type, glenoid version and the point of glenohumeral contact.

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