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Humeral avulsion of the glenohumeral ligament (HAGL)

Case contributed by Yasser Asiri
Diagnosis almost certain

Presentation

Shoulder trauma.

Patient Data

Age: 25 years
Gender: Female

Wavy contour of the joint capsule, with a detachment of the anterior band of inferior glenohumeral ligament (IGHL), which shows the apparent 'J sign'. Extravasation of the intra-articular contrast into the adjacent soft tissues is seen. The findings are in keeping with a HAGL. 

Case Discussion

The imaging appearances are most likely compatible with humeral avulsion of the glenohumeral ligament 1. Overdistention of the joint capsule during arthrography may result in contrast extravasation and may mimic capsular tear 2, although this is disputed by many Orthopedic surgeons.  

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