Presentation
Left shoulder stiffness, and pain.
Patient Data
Pathologic glenoid retroversion 26° (>15°) and posterior erosion, yielding a biconcave with glenoid, moderate bone loss. There's also osteophytes, severe joint narrowing and subchondral cyst. Moderate effusion within biceps long head tendon sheath.
The axis of rotation for retroversion (Friedman method). The degree of retroversion is demonstrated as the angle between the line perpendicular to the Friedman line (line of neutral glenoid version) and the line connecting the anterior and posterior glenoid margins.
Case Discussion
Primary osteoarthritis commonly leads to posterosuperior joint narrowing, while secondary osteoarthritis superimposed on rheumatoid or inflammatory arthropathy leads to axial, symmetric, and diffuse joint space narrowing. The B2 glenoid is defined by asymmetric posterior bone loss with the development of a biconcavity and posterior translation of the humeral head. The B2 subtype, or biconcave glenoid, is characterized by a normal anterior glenoid (paleoglenoid) that represents the native glenoid fossa and varying amounts of posterior bone loss. The humeral head translates posteriorly to articulate with the new posterior concavity (neoglenoid). Progressive bone loss results in increasing glenoid retroversion, which must be corrected during anatomic shoulder arthroplasty. Glenoid bone erosion is encountered frequently in patients with rotator cuff tear arthropathy, which is the primary indication for RSA.
Radiographer: TSRM Fabio Imola
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