The problem: A lot of the difficulty people have in reporting shoulder MRI and particularly the glenoid labrum is in having a clear understanding of the MRI anatomy. This leads to confusion in differentiating normal glenoid labrum variants from labral tears and SLAP tears.

The solution: The humble pear. Only a few dollars a kilo but priceless in better visualising the practical glenoid anatomy.

What to Look For: When you look at the glenoid on a sagital MRI it looks like a pear. So lets use the pear to divide the glenoid into the  important quadrants when reporting shoulder MRI.  Using this, diagnosing labral and SLAP tears and differentiating them from normal variants becomes much easier.

• Equator: Divides glenoid into superior and inferior halves

  • On axial MRI images, the level of the tip of the coracoid is at the level of the equator

  • Use this as your marker for superior and inferior halves

• Most labral tears occur in the Superior and Anterior Inferior quadrants. Posterior quadrant less frequent

• Anatomical labral variants occur in the Superior and Anterior Superior Quadrants

• Biceps insertion at the Superior quadrant is an important landmark in differentiating normal labral variants and SLAP tears

• Normal variants do not extend posterior to the biceps insertion or inferior to the equator

• In the next part, we look at Normal Variants of the Glenoid Labrum and how to differentiate them from tears.