Recurrent anterior glenohumeral instability - Hill-Sachs and bony Bankart lesions

Comminuted, mildly displaced (posterolaterally) and malunited fracture of posterolateral aspect of head of humerus, involving greater tuberosity. Few bone fragments are seen adjacent to it and along posteroinferior aspects of glenohumeral joint. 

Depressed fracture of the posterosuperior aspect of head of humerus is seen, measuring approx. 19 mm in transverse dimension and 5.4 mm in depth. 

Tear of the anteroinferior glenoid labrum is seen, with superior extension approx. from approx. 2-6 o’clock position. Mild elevation of adjacent periosteum is seen, which appears attached the underlying bone. Cortical irregularity and bone loss is seen with small bone fragment attached to anteroinferior bony glenoid.  

Bone loss is approx. 27 %.

Rest of the glenoid labrum also appears irregular and attenuated with a large septated cyst, measuring approx. 43 x 22 mm at the posteroinferior aspect of the glenohumeral joint. 

Mild fluid is seen along biceps tendon in the bicipital groove with tiny foci of calcification adjacent to it. 

Supraspinatus tendon including the myotendinous junction appears diffusely thinned out and attenuated with multiple interstitial tears. However, no obvious retraction of torn fibers is seen. No evidence of volume loss or fatty atrophy of muscle fibers is seen. 

Infraspinatus tendinosis is seen with no obvious tear. 

Acromio-clavicular joint is unremarkable. 

Subscapularis and biceps tendons are unremarkable. Low-grade strain of superior fibers of subscapularis and infraspinatus muscles is seen.