Humeral avulsion of the glenohumeral ligament (fluoroscopy and MRI arthrogram)

Case contributed by Dr Dai Roberts

Presentation

Previous anterior glenohumeral joint dislocation. Ongoing instability.

Patient Data

Age: 35 years
Gender: Male

Injection of iodinated contrast confirms an intra-articular needle position.  The latter image, taken after the arthrogram solution has been given, shows an irregular contour to the axillary pouch suggestive of a HAGL.  

HAGL with a patulous axillary pouch. 

Bony Bankart involving 20% of the glenoid face and a displaced inferior labral fragment. 

Additional circumferential labral tear, with chondrolabral separation posteriorly and a SLAP tear.  Shallow Hill-Sachs defect.

Intact rotator cuff tendons. 

Case Discussion

Humeral avulsion of the (inferior) glenohumeral ligament (HAGL) can occur after dislocation, and be evident in isolation or associated with other injuries.  The axillary pouch, which is made up of the inferior glenohumeral ligaments, should be a smooth contour.  

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