Presentation
Shoulder pain with limited range of motion after car accident.
Patient Data
There is depression in the posterolateral aspect of the humeral head with significant surrounding edema suggesting a Hill-Sachs lesion associated with a fragmented, avulsed anteroinferior labroligamentous complex, features representing Bankart lesion with concurrent Hill-Sachs lesion.
No definite bony Bankart.
Moderate joint effusion.
Minimal fluid in the subscapular recess.
Case Discussion
Anterior dislocation is the most common type of shoulder dislocation, when it is accompanied by an anterior glenoid labrum tear is called a Bankart lesion.
The humeral head usually dislocates in an anteroinferior direction.
Bankart lesions result from high-energy trauma or sports injuries (either acute injuries or overuse injuries from repetitive arm motions).
On radiography, the Hill-Sachs lesion is best demonstrated on an AP radiograph with the arm in internal rotation.
On cross-sectional imaging, a Hill-Sachs lesion should be above the level of the coracoid, as there is a normal concavity of the humeral head located about the level of the coracoid that can be confused with a chronic Hill-Sachs lesion.