Hill-Sachs lesion and SLAP lesion

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Previous dislocated shoulder.

Patient Data

Age: 20 years
Gender: Male

Technique: multiplanar, multi-sequence imaging has been performed after intra-articular gadolinium administration. Note is made of the CT shoulder from 28.8.2013.

Findings There is a large defect of the anteroinferior glenoid labrum between the 2 o'clock and 5 o'clock position with no associated periosteal stripping. There is associated chronic scarring and minor calcification in the anteriorly displaced fragment. The glenoid deficiency measures approximately 28%. There is a discrete bone-cartilage fragment lying within the axillary pouch measuring approximately 8mm. There is a Hill-Sachs lesion lesion measuring 14x6 mm. The biceps tendon is normal. There is a type II superior labral anterior and posterior (slap) type II lesion. The AC joint is normal. The rotator cuff tendons are intact.

Comment

1. Large anterior glenoid deficiency with scarring/osseous fragments of the anterior labral complex WITHOUT periosteal striping.

2. SLAP II lesion. Probable biceps tendinosis at the outlet.

3. no HAGL or ALPSA lesions.

4. bone-cartilage fragment lying within the axillary pouch.

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