Presentation
Anterior shoulder instability after dislocation. Positive labral testing on examination.
Patient Data
Chondrolabral separation with intact periosteum involving the anteroinferior glenoid labrum and extending anteriorly into the posterosuperior labrum involving the entire AP width of the long head of biceps origin. The tear extends from 10 o'clock to 6 o'clock anteriorly (3 o'clock anterior). Large associated paralabral cyst, better appreciated on the T2 fat-saturated images, which extends into the suprascapular notch and spinoglenoid notch where it displaces the suprascapular nerve medially. Minimal infraspinatus muscle atrophy. Small Hill-Sachs defect.
Case Discussion
Findings are in keeping with a Perthes lesion and SLAP tear, with the presence of a large paralabral cyst, extending into the suprascapular notch and spinoglenoid notch.
Glenohumeral arthrography is most often performed to assess for glenoid labrum tears. Paralabral cysts form when there are one-way valves at a labral tear which fill with fluid. The suprascapular nerve passes through both the suprascapular and spinoglenoid notches, and injury and /or compression of the nerve will cause a suprascapular neuropathy.
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