Hill-Sachs and Bankart lesions

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Past history of trauma with dislocation, now painful movements.

Patient Data

Age: 25 years
Gender: Male

PD fat-sat images show hyperintensity in anteroinferior labrum, possibly extending to anterosuperior labrum. Posterior labrum appears normal.

Small compression fracture seen along the posterolateral aspect of head of humerus. It measures 13 mm in transverse dimensions and 4 mm in depth.

Mild supraspinatus and subscapularis tendinosis are seen with no obvious rotator cuff tear.

Small subcortical cysts seen in the superior aspect of head of humerus.

Mild marrow edema is seen in distal end of clavicle.

Tendinosis of the intracapsular segment of biceps tendon is seen.

Case Discussion

PD fat-sat images show hyperintensity in anteroinferior labrum, possibly extending to anterosuperior labrum consistent with labral tear (Bankart lesion).

Small compression fracture seen along posterolateral aspect of head of humerus in keeping with Hill-Sachs lesion.

While reporting , care must be taken to avoid misinterpreting the normal depression along the lateral aspect of head of humerus as Hill-Sachs lesion. Hill-Sachs lesions are seen at or above the level of the coracoid process.

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