Recurrent posterior glenohumeral instability

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Recurrent shoulder dislocations.

Patient Data

Age: 30 years
Gender: Male

Normal glenohumeral alignment. Large reverse Hill-Sachs defect. No glenoid fracture identified. 

Normal glenohumeral alignment; joint space is preserved. Large reverse Hill-Sachs defect with a "hatcheted" appearance suggests recurrent episodes of dislocation. Mild glenoid retroversion. Mild rounding of the posteroinferior glenoid. No glenoid hypoplasia.

Large non-acute reverse Hill-Sachs defect. Rounding of the posteroinferior bony glenoid. Postoinferior labrum is thickened and rounded suggestive of scarring with chondrolabral junction high signal suspicious for a tear. No paralabral cyst. 

Case Discussion

Recurrent glenohumeral instability is far more common anteriorly than posteriorly but there are some imaging features in common:

  • "hatcheted" appearance of the Hill-Sachs defect
  • rounding of the glenoid from repeated impactions
  • scarring of the labrum from repeated injuries

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