ALPSA lesion

Case contributed by Ahmed Abdrabou
Diagnosis almost certain


Shoulder pain and limited movement following closed reduction of shoulder dislocation 4 days ago.

Patient Data

Age: 27 years old
Gender: Male

Acute edema of the posterolateral humeral head consistent with bony Hill Sachs lesion.

There is medial displacement of the inferior glenohumeral labroligamentous attachment to the glenoid with intact scapular periosteum.

Annotated image

Red arrows refer to the displaced IGHL complex

Case Discussion

Anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion occurs following anterior shoulder dislocation. There is medial displacement and inferior shift of the IGHL complex with intact scapular periosteum. Associated joint effusion, bone edema and HIll Sachs injuries may be seen.

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