Acute Hill-Sachs and ALPSA lesions

Case contributed by Dr Ahmed Abdrabou

Presentation

Traumatic shoulder dislocation 2 days ago followed by pain and limitation of movement

Patient Data

Age: 20 years
Gender: Male

A bony defect of the posterolateral aspect of the humeral head with underlying marrow contusion consistent with acute Hill-Sachs injury due to recent anterior shoulder dislocation. There is associated avulsion of the anteroinferior labrum with medial displacement yet preserved periosteal attachment consisstent with anterior labroligamentous posterior sleeve avulsion lesion (ALPSA).

Case Discussion

Recurrent anterior shoulder dislocation can result in bony defect in the posterolateral humeral head (Hill-Sachs lesion) when it hits the anterior glenoid as well as various lesions involving the anteroinferior glenoid labrum including Bankart, ALPSA and Perthes lesions.

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