Humeral head deviation and velocity in multidirectional instability of the glenohumeral joint: a cine magnetic resonance imaging study

Abstract

Background

Manual clinical tests for shoulder instability rely heavily on subjective assessments of humeral head translation, making objective quantification challenging. This study hypothesized that patients with multidirectional glenohumeral instability (MDI) would demonstrate greater humeral head deviation and faster deviation velocity than healthy controls during active shoulder rotation, as assessed using cine magnetic resonance imaging (MRI).

Methods

Fourteen participants (eight shoulders with MDI and 20 healthy shoulders) underwent cine MRI while performing active shoulder rotation with the arm at the side. Humeral head deviation, deviation amplitude, and deviation velocity were calculated and compared between the groups using Welch's t-test.

Results

The MDI group showed significantly greater humeral head deviation, wider amplitude of deviation, and faster deviation velocity than the control group (P = .008 for anterior deviation, P = .009 for posterior deviation). The deviation amplitude exceeded 35% of the glenoid width in MDI shoulders, surpassing established clinical thresholds.

Conclusion

Patients with MDI demonstrated quantifiable dynamic instability on cine MRI. This modality may provide objective support for clinical findings. However, validation in larger cohorts is warranted to confirm these findings, given the limited number of MDI shoulders (n = 8).