MR arthrographic assessment of suspected posteroinferior labral lesions using flexion, adduction, and internal rotation positioning of the arm: preliminary experience.

Abstract

Imaging the shoulder in the position of flexion, adduction, and internal rotation (FADIR) may be useful in characterizing lesions of the posteroinferior labrum. The purpose of this preliminary study is to illustrate the diagnostic utility of FADIR positioning in the assessment and characterization of posteroinferior labral tears. In the FADIR position, the arm is placed across the chest, with the hand on the contralateral shoulder and palm facing outwards. FADIR positioning was performed if there was a subtle or equivocal abnormality of the posteroinferior labrum on conventional MR arthrography sequences. A retrospective review of the charts of 9 people who were imaged using FADIR positioning in addition to routine MR arthrographic sequences of the shoulder was performed. The review included the indication for the study, documentation of presence of clinical posterior instability, and surgical correlation, where available. In all 9 patients, FADIR positioning helped confirm, exclude, or better characterize a posteroinferior labral abnormality by increasing the diagnostic confidence. Flexion, adduction, and internal rotation positioning appears to be a useful adjunct in evaluating patients with equivocal or subtle posteroinferior labral abnormalities on conventional MR arthrography sequences.