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Recurrent anterior shoulder instability

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Right shoulder recurrent anterior dislocations.

Patient Data

Age: 50 years
Gender: Male
  • joint effusion
  • anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion
  • posterolateral impression of the humeral head with adjacent bone edema, indicating a Hill-Sacs lesion
  • abnormal intrasubstance increased fluid signal along with supraspinatus tendon bursal side fibers related to tendinosis 
  • subacromion - subdeltoid bursa
  • fluid signal around the long head of the biceps tendon due to tenosynovitis
  • low lying type I acromion

Case Discussion

Chronic anterior shoulder dislocations with ALPSA and Hill-sacs lesions. Almost all ALPSA lesions happened in the shoulders with chronic dislocations.

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