Acute Hill-Sachs and Perthes lesions

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Traumatic right anterior shoulder dislocation 3 days ago followed by severe pain and immobility.

Patient Data

Age: 25 years
Gender: Female

Moderate joint effusion

A bony defect of the posterolateral aspect of the humeral head with underlying marrow edema and contusion consistent with acute Hill-sacs injury

There is an associated avulsion of the anteroinferior glenoid labrum. The scapular periosteum remains intact but is stripped medially.

The fluid signal is present within the LHBT tendon sheath related to tenosynovitis.

 

Case Discussion

The findings are consistent with Hill-sacs and Perthes lesions in the background of anterior shoulder dislocation.

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