Humeral avulsion of the glenohumeral ligament

Humeral avulsion of the glenohumeral ligament, is not surprisingly abbreviated to HAGL lesion. As the name suggests, there is avulsion of the inferior glenohumeral ligament (IGHL) from its humeral insertion. It can be associated with a bony avulsion fracture in which case it is referred to (again not surprisingly) as bony humeral avulsion of the glenohumeral ligament (BHAGL lesion).

HAGL is much more frequent in young men engaged in contact sports.

Clinical presentation is usually with a history shoulder dislocation. Anterior shoulder pain, apprehension in abduction and lateral rotation, subjective instability and crepitus are noted on examination. 

HAGL most often results from anterior shoulder dislocation due to forced hyperabduction and external rotation of the arm.

MRI is the modality of choice for assessment of HAGL, especially as the finding may be difficult to diagnose on arthroscopy. Typical findings include:

Shoulder instability as a result of HAGL lesions is reported to occur in ~5% (range 2-10%) 2.

The degree of instability and presence of other associated injuries determines whether surgical repair is required.

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Article Information

rID: 1464
Section: Gamuts
Synonyms or Alternate Spellings:
  • HAGL lesion
  • Humeral avulsion of the glenohumeral ligament (HAGL lesion)
  • HAGL

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