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SHART: shoulder hyperabduction radiological test

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate and quantify laxity of the inferior glenohumeral ligament (IGHL) in post-traumatic anterior instability of the shoulder with the shoulder hyperabduction radiological test (SHART) and correlate it with arthroscopic findings.

Methods

This prospective study included 21 patients undergoing arthroscopic stabilization for anteroinferior shoulder instability. The SHART test was performed as follows: a bilateral AP radiograph was performed in the supine position, and radiographs were compared. The shoulder was positioned in passive maximum abduction in neutral rotation, and neither general nor regional anesthesia was used. The angle between the axis of the humeral shaft and the line drawn between the lateral border of the scapular tubercle and the inferior edge of the glenoid fossa was measured. During arthroscopy, IGHL distension was classified into 4 stages according to the Detrisac classification. Extensive distension was considered to be the stages 3 and 4.

Results

The correlation between the SHART test and Detrisac staging was found to be statistically significant (P = 0.02). In the presence of a difference of more than 15° between the pathological and the contralateral shoulder on radiographs, the SHART test shows 87% of IGHL distension, Detrisac stages 3 and 4.

Conclusion

We suggest that the SHART test should be added to conventional preoperative imaging tests for anterior instability.

Level of evidence

Development of diagnostic criteria in a consecutive series of patients, Level II.

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Authors and Affiliations

  1. Orthopaedic Surgery Department, Ambroise Paré Hospital, 9 avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France

    Franck Jouve, Charles Schlur, Shahnaz Klouche, Thomas Bauer & Philippe Hardy

  2. Radiology Department, Ambroise Paré Hospital, 9 avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France

    Benoit Rousselin

Authors
  1. Franck Jouve
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  2. Charles Schlur
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  3. Shahnaz Klouche
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  4. Thomas Bauer
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  5. Benoit Rousselin
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  6. Philippe Hardy
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Correspondence to Shahnaz Klouche.

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Jouve, F., Schlur, C., Klouche, S. et al. SHART: shoulder hyperabduction radiological test. Knee Surg Sports Traumatol Arthrosc 19, 2080–2084 (2011). https://doi.org/10.1007/s00167-011-1438-8

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  • DOI: https://doi.org/10.1007/s00167-011-1438-8

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