Presentation
Pain and functional limitation of the right shoulder in skier, after fall with arm in hyperabduction.
Patient Data
Arthrogram MRI right shoulder
Coronal T1 fat suppressed image shows that the antero-inferior labrum is intact but the anterior and posterior band of the IGHL are avulsed at its glenoid attachment, with lax and inferiorly displaced fibers: "reverse J sign" (yellow arrow). Note the loss of the normal U-shape of the axillary recess. The leak is visible in the caudal direction and along the lower edge of the glenoid. The tendons of the rotator cuff are normal.
Case Discussion
For the detection of HAGL, the joint cavity should be well distended with contrast agent or joint effusion. On coronal MRI image, the distended axillary recess is seen as U-shaped, which becomes "J-shaped" in a HAGL lesion and "J reverse" in the GAGL lesion.
Radiologic Technologist: Stefano Paganelli
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