Objective To evaluate the diagnostic performance of magnetic resonance (MR) arthrography of the shoulder in the diagnosis of anteroinferior labrum lesions, using arthroscopy as the reference standard and to classify these lesions. Methods Institutional review board approval was obtained. The study population included 59 consecutive patients with history and clinical diagnosis of acute or chronic anterior shoulder instability. A total of 62 MR arthrograms were performed, since three patients had undergone a bilateral procedure. Arthroscopy, which was performed within a mean of 3 months (range 2–5 months) after MR arthrography, was used as the reference standard. Sensitivity, specificity, accuracy, positive and negative predictive values were then calculated. Results MR arthrography showed a sensitivity of 96 % and a specificity of 80 % for the overall detection of anteroinferior labrum abnormalities. The diagnostic accuracy was 95 % and the positive and negative predictive values were 98 % and 66 % respectively. Ten lesions were non-classifiable on surgery, of which eight were non classifiable on MR arthrography also. Conclusions MR arthrography is highly accurate for the detection and classification of shoulder anteroinferior labrum lesions. Shoulder surgeons can confidently rely on this method to determine which patients will benefit from arthroscopy. Main Messages • MR arthrography is accurate for the detection and classification of shoulder labrum lesions. • MR arthrography is a valuable tool for the preoperative planning in acute or chronic instability. • Shoulder surgeons can rely on this method to determine which patients will benefit from arthroscopy.

Study Design. Study design randomized intra- and inter-reader reproducibility study. Objective. To evaluate reproducibility of quantitative morphometry (QM) and agreement of dichotomous fracture/no-fracture status on lateral spinal radiographs acquired during routine clinical practice using a clinical workflow tool. Summary of Background Data. Several recent guidelines have underlined the importance of Genant semi-quantitative scoring and selective QM to confirm and grade suspected vertebral fractures in clinical practice. Methods. Thoracic and lumbar spine radiographs were acquired from 98 consecutive subjects (mean age, 60.1 ± 11.7 yr) attending the clinic for osteoporosis evaluation. For each subject, QM and Genant semi-quantitative scoring were performed on all evaluable vertebrae from L4 to T4 using a software workflow tool. A radiologist and an experienced radiographical technician performed 2 repeat reading sessions of the radiographs 12 months apart, blinded to each other's results; for the second read, the cases were anonymized and the order was randomized. Results. Inter-reader reproducibility results were 3.1% and 3.2% coefficient of variation (%) for heights, 0.030 and 0.031 root mean square standard deviation for height ratios. For intrareader reproducibility, these values were 2.2% and 3.5% coefficient of variation %; 0.023 and 0.034 root mean square standard deviation. Kappa score results for agreement of dichotomous fracture/no-fracture status were 0.67 and 0.72 (inter-rater) and 0.50 and 0.67 (intrarater). Conclusion. The software assessed in this study is a reliable clinical tool that facilitates QM and Genant semi-quantitative scoring of the spine in routine clinical practice. Level of Evidence: 3