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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
Multidirectional instability (MDI)
AMBRII (mnemonic for MDI features)
Atraumatic
Multidirectional
Bilateral
Rehabilitation is usual treatment
Inferior capsule: If surgery, capsule is tightened
Interval (rotator) is also tightened/reconstructed if surgery
Synonyms
Recurrent atraumatic instability
Definitions
Pain from excessive anterior, posterior, and inferior humeral head translation without labral tear
IMAGING
General Features
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Reporting Tips
Selected References
Longo UG et al: Multidirectional instability of the shoulder: a systematic review. Arthroscopy. 31(12):2431-43, 2015
Burt DM: Arthroscopic repair of inferior labrum from anterior to posterior lesions associated with multidirectional instability of the shoulder. Arthrosc Tech. 3(6):e727-30, 2014
Schaeffeler C et al: MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder. Eur Radiol. 24(6):1376-85, 2014
Lee HJ et al: Multidirectional instability of the shoulder: rotator interval dimension and capsular laxity evaluation using MR arthrography. Skeletal Radiol. 42(2):231-8, 2013
von Eisenhart-Rothe R et al: Simultaneous 3D assessment of glenohumeral shape, humeral head centering, and scapular positioning in atraumatic shoulder instability: a magnetic resonance-based in vivo analysis. Am J Sports Med. 38(2):375-82, 2010
Provencher MT et al: An analysis of the rotator interval in patients with anterior, posterior, and multidirectional shoulder instability. Arthroscopy. 24(8):921-9, 2008
Kim SH et al: Loss of chondrolabral containment of the glenohumeral joint in atraumatic posteroinferior multidirectional instability. J Bone Joint Surg Am. 87(1):92-8, 2005
Inui H et al: Three-dimensional relationship of the glenohumeral joint in the elevated position in shoulders with multidirectional instability. J Shoulder Elbow Surg. 11(5):510-5, 2002
Levine WN et al: Treatment of the athlete with multidirectional shoulder instability. Orthop Clin North Am. 32(3):475-84, 2001
An YH et al: Multidirectional instability of the glenohumeral joint. Orthop Clin North Am. 31(2):275-85, 2000
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
Multidirectional instability (MDI)
AMBRII (mnemonic for MDI features)
Atraumatic
Multidirectional
Bilateral
Rehabilitation is usual treatment
Inferior capsule: If surgery, capsule is tightened
Interval (rotator) is also tightened/reconstructed if surgery
Synonyms
Recurrent atraumatic instability
Definitions
Pain from excessive anterior, posterior, and inferior humeral head translation without labral tear
IMAGING
General Features
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Reporting Tips
Selected References
Longo UG et al: Multidirectional instability of the shoulder: a systematic review. Arthroscopy. 31(12):2431-43, 2015
Burt DM: Arthroscopic repair of inferior labrum from anterior to posterior lesions associated with multidirectional instability of the shoulder. Arthrosc Tech. 3(6):e727-30, 2014
Schaeffeler C et al: MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder. Eur Radiol. 24(6):1376-85, 2014
Lee HJ et al: Multidirectional instability of the shoulder: rotator interval dimension and capsular laxity evaluation using MR arthrography. Skeletal Radiol. 42(2):231-8, 2013
von Eisenhart-Rothe R et al: Simultaneous 3D assessment of glenohumeral shape, humeral head centering, and scapular positioning in atraumatic shoulder instability: a magnetic resonance-based in vivo analysis. Am J Sports Med. 38(2):375-82, 2010
Provencher MT et al: An analysis of the rotator interval in patients with anterior, posterior, and multidirectional shoulder instability. Arthroscopy. 24(8):921-9, 2008
Kim SH et al: Loss of chondrolabral containment of the glenohumeral joint in atraumatic posteroinferior multidirectional instability. J Bone Joint Surg Am. 87(1):92-8, 2005
Inui H et al: Three-dimensional relationship of the glenohumeral joint in the elevated position in shoulders with multidirectional instability. J Shoulder Elbow Surg. 11(5):510-5, 2002
Levine WN et al: Treatment of the athlete with multidirectional shoulder instability. Orthop Clin North Am. 32(3):475-84, 2001
An YH et al: Multidirectional instability of the glenohumeral joint. Orthop Clin North Am. 31(2):275-85, 2000
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