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PURPOSE: To prospectively assess the accuracy of unenhanced magnetic resonance (MR) imaging in the detection and localization of labral injuries. MATERIALS AND METHODS: One hundred three patients with clinically suspected shoulder injuries were prospectively examined with unenhanced MR imaging. A combination of gradient-echo and high-resolution fast-spin-echo axial pulse sequences were used. Surgical correlation was obtained in all patients. RESULTS: At surgery, 37 torn anterior, 36 torn superior, and 19 torn posterior labral were identified. The sensitivity for detection of these tears with MR imaging was 100%, 86%, and 74%, respectively; the specificity was 95%, 100%, and 95%, respectively. Overall, unenhanced MR imaging was 95% accurate in the detection of labral injuries. CONCLUSION: With appropriate pulse sequences, unenhanced MR imaging of the shoulder is an accurate technique for the detection and localization of labral injuries.

PURPOSE: To determine the value of magnetic resonance (MR) imaging in the clinical management of chronic refractory lateral epicondylitis. MATERIALS AND METHODS: Coronal three-dimensional Fourier transform, multiplanar gradient-recalled-echo, and fat-suppressed sagittal images were obtained in 33 patients. Twenty of these patients underwent surgical debridement and/or primary tendon repair and were included in the correlative study. Surgical and pathologic reports were reviewed to determine the location and gross characteristics of the tissue. RESULTS: Findings at MR imaging correlated with the surgical findings of primary degeneration of the extensor carpi radialis brevis (n = 20). Histopathologic examination demonstrated neovascularization, disruption of collagen, and mucoid degeneration without inflammation. CONCLUSION: The use of MR imaging in patients with recalcitrant lateral epicondylitis assists in surgical planning. The definition of tendon degeneration and degree of tear, as depicted on MR image...