Perthes lesion

Case contributed by Dr Yair Glick

Presentation

Whiplash injury and right shoulder pain following a motor vehicle accident.

Patient Data

Age: 40 years
Gender: Female
MRI

Shoulder MR arthrography

Partial anterior inferior chondrolabral separation at 2-4 o'clock.
Supraspinatus, infraspinatus, subscapularis, and teres minor tendons exhibit normal thickness, continuity and signal. The muscles are of normal thickness, without signs of atrophy or fatty infiltration. The long head of biceps exhibits normal thickness and signal and is located in its groove.
No fracture of the glenoid and no signs of hyaline cartilage damage or erosion.
Head of humerus and acromioclavicular joint: no pathological finding.

Case Discussion

Persistent shoulder pain over a year after a motor vehicle accident. Partial anterior inferior chondrolabral separation on MR arthrography suspicious for a Perthes lesion (especially on axial PDW SPAIR sequence).
The differential is a sublabral recess, an anatomic variant.

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Case information

rID: 55963
Case created: 3rd Oct 2017
Last edited: 4th Oct 2017
Inclusion in quiz mode: Included
Institution: Hillel Yaffe Medical Center

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