Superior sublabral sulcus
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The superior sublabral sulcus isor superior sublabral recess refers to a small synovial lined gap or detachment between the labral free edge and the cartilage and forms a normal variant of the biceps lalbral complex 1.
Gross Anatomy
The superior sublabrallabral sulcus or recess, which is normally present at thea small groove covered by synovium2 caused by a loose attachment of the superior labrum to the the glenoid rim. It is most often located in the anterior part part of the superior labrum but can be also found more centrally 2 at the proximal attachment of the long head biceps tendon to the glenoid labrum.
The sublabral recess can feature different depths ranging from <2 mm to >5 mm 2,3.
Radiographic features
MRI/MRA
A sublabral recess is best detected on coronal oblique orientated fat saturated T1 weighted images on MR athrography 2 or in partients with joint effusion1.
Typical features on imaging include the following 1,4:
- anterior location only extending to the posterior insertion point of the biceps tendon origin
- smooth regular contour
- medial orientation parallelling the glenoid cartilage underneath
Clinical importance
A superior sublabral sulcus has been described as being shallow or deepand is a frequent finding on MRI and maycan be continuous withfound in more than 70% of cases 2,3. It features a sublabral foramen if present.
Differential diagnosis
- similar appearance and needs to be differentiated from type II SLAP lesion
-<p>The <strong>superior sublabral sulcus</strong> is a normal <a href="/articles/glenoid-labrum-variants">variant</a> of the <a title="superior sublabral recess" href="/articles/superior-sublabral-recess">superior sublabral recess</a>, which is normally present at the attachment of the biceps tendon to the <a href="/articles/glenoid-labrum">glenoid labrum</a>.</p><p>The superior sublabral sulcus has been described as being shallow or deep and may be continuous with a <a href="/articles/sublabral-foramen">sublabral foramen</a> if present.</p><h4>Differential diagnosis</h4><ul><li>type II <a href="/articles/superior-labral-anterior-posterior-tear">SLAP lesion</a>-</li></ul>- +<p>The <strong>superior sublabral sulcus</strong> or <strong>superior sublabral recess</strong> refers to a small synovial lined gap or detachment between the labral free edge and the cartilage and forms a normal variant of the biceps lalbral complex <sup>1</sup>.</p><h4>Gross Anatomy</h4><p>The superior labral sulcus or recess is a small groove covered by <a href="/articles/synovium">synovium</a> <sup>2</sup> caused by a loose attachment of the superior labrum to the the glenoid rim. It is most often located in the anterior part part of the superior labrum but can be also found more centrally <sup>2</sup> at the proximal attachment of the <a href="/articles/long-head-of-biceps-tendon">long head biceps tendon</a> to the <a href="/articles/glenoid-labrum">glenoid labrum</a>.</p><p>The sublabral recess can feature different depths ranging from <2 mm to >5 mm <sup>2,3</sup>.</p><h4>Radiographic features</h4><h5>MRI/MRA</h5><p>A sublabral recess is best detected on coronal oblique orientated fat saturated <a href="/articles/t1-weighted-image">T1 weighted images</a> on MR athrography <sup>2</sup> or in partients with <a href="/articles/joint-effusion">joint effusion</a> <sup>1</sup>.</p><p>Typical features on imaging include the following <sup>1,4</sup>:</p><ul>
- +<li>anterior location only extending to the posterior insertion point of the biceps tendon origin</li>
- +<li>smooth regular contour</li>
- +<li>medial orientation parallelling the glenoid cartilage underneath</li>
- +</ul><h4>Clinical importance</h4><p>A superior sublabral sulcus and is a frequent finding on MRI and can be found in more than 70% of cases <sup>2,3</sup>. It features a similar appearance and needs to be differentiated from type II <a href="/articles/superior-labral-anterior-posterior-tear">SLAP lesion</a> <sup>5</sup>. The latter is usually characterised by irregular contours can extend posteriorly to the biceps tendon anchor <sup>2 </sup>or laterally into the substance of the glenoid labrum <sup>1</sup>.</p>
References changed:
- 6. De Maeseneer M, Van Roy F, Lenchik L et-al. CT and MR arthrography of the normal and pathologic anterosuperior labrum and labral-bicipital complex. Radiographics. 2000;20 Spec No (suppl 1): S67-81. <a href="http://radiographics.rsna.org/content/20/suppl_1/S67.full">Radiographics (full text)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/11046163">Pubmed citation</a><span class="ref_v3"></span>
- 7. Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins. (2011) ISBN:1609139437. <a href="http://books.google.com/books?vid=ISBN1609139437">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1609139437">Find it at Amazon</a><span class="ref_v3"></span>
- 1. Dunham K, Bencardino J, Rokito A. Anatomic Variants and Pitfalls of the Labrum, Glenoid Cartilage, and Glenohumeral Ligaments. Magn Reson Imaging Clin N Am. 2012;20(2):213-28, x. <a href="https://doi.org/10.1016/j.mric.2012.01.014">doi:10.1016/j.mric.2012.01.014</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22469401">Pubmed</a>
- 2. Kreitner K, Botchen K, Rude J, Bittinger F, Krummenauer F, Thelen M. Superior Labrum and Labral-Bicipital Complex: MR Imaging with Pathologic-Anatomic and Histologic Correlation. AJR Am J Roentgenol. 1998;170(3):599-605. <a href="https://doi.org/10.2214/ajr.170.3.9490937">doi:10.2214/ajr.170.3.9490937</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/9490937">Pubmed</a>
- 3. Smith D, Chopp T, Aufdemorte T, Witkowski E, Jones R. Sublabral Recess of the Superior Glenoid Labrum: Study of Cadavers with Conventional Nonenhanced MR Imaging, MR Arthrography, Anatomic Dissection, and Limited Histologic Examination. Radiology. 1996;201(1):251-6. <a href="https://doi.org/10.1148/radiology.201.1.8816553">doi:10.1148/radiology.201.1.8816553</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/8816553">Pubmed</a>
- 4. Tuite M & Orwin J. Anterosuperior Labral Variants of the Shoulder: Appearance on Gradient-Recalled-Echo and Fast Spin-Echo MR Images. Radiology. 1996;199(2):537-40. <a href="https://doi.org/10.1148/radiology.199.2.8668808">doi:10.1148/radiology.199.2.8668808</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/8668808">Pubmed</a>
- 5. Jin W, Ryu K, Kwon S, Rhee Y, Yang D. MR Arthrography in the Differential Diagnosis of Type II Superior Labral Anteroposterior Lesion and Sublabral Recess. AJR Am J Roentgenol. 2006;187(4):887-93. <a href="https://doi.org/10.2214/ajr.05.0955">doi:10.2214/ajr.05.0955</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/16985130">Pubmed</a>
- 1. De Maeseneer M, Van Roy F, Lenchik L et-al. CT and MR arthrography of the normal and pathologic anterosuperior labrum and labral-bicipital complex. Radiographics. 2000;20 Spec No (suppl 1): S67-81. <a href="http://radiographics.rsna.org/content/20/suppl_1/S67.full">Radiographics (full text)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/11046163">Pubmed citation</a><span class="ref_v3"></span>
- 2. Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins. (2011) ISBN:1609139437. <a href="http://books.google.com/books?vid=ISBN1609139437">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1609139437">Find it at Amazon</a><span class="ref_v3"></span>
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