Presentation
Left shoulder pain following a volleyball-related injury. The pain is associated with an audible clunk.
Patient Data
MRI Arthrogram left shoulder
MR arthrography shows contrast agent between the posterior glenoid and labrum (h 6-9) without labral displacement.
Case Discussion
The Kim lesion is due to a posteriorly and inferiorly directed force in young, active individuals performing overhead activities; it is equivalent to the Perthes lesion, but involves the posterior labrum. Scapula periosteum remains intact. The most common presentation is shoulder pain following repetitive overhead activity. This tear, which is not a complete labral avulsion, is called a “marginal crack”. This lesion if untreated, it can lead to persistent posterior shoulder instability. Kim et al (2004) simplifies the grading of posterior labral tears into four subgroups.
- Type 1: Incomplete detachment. The labrum (posteroinferior portion) is detached from the glenoid margin but not displaced.
- Type 2: Kim Lesion (marginal crack).
- Type 3: Chondrolabral erosion.
- Type 4: Flap tear of the labrum.
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