Reverse Hill-Sachs and Bankart lesion
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History of shoulder trauma. Clinically pain with abduction and external rotation.
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Images show the humeral head in internal rotation. It appears posteriorly displaced in relation to the glenoid. A wedge-shaped bony defect is visible in the anteromedial humeral head, There is a tear of the posteroinferior labrum (between 6 o'clock and 9 o'clock), without abnormalities of the posterior glenoid rim. There is redundant soft tissue adjacent to the humeral head defect, most likely representing a torn MGHL. High signal changes in the biceps tendon as well as within the biceps anchor, corresponding with tendinosis. The rotator cuff tendons are intact.
Typical findings of reverse Hill-Sachs and reverse Bankart lesions, which are associated with posterior shoulder dislocation. The mechanism of injury causes the detachment of the posteroinferior labrum and the avulsion of the adjacent posterior capsular periosteum. As a result, the posterior capsule and the posterior band of the IGHL become lax, which in turn leads to posterior glenohumeral instability 1.
- 1. Nehal Shah, Glenn A. Tung. Imaging Signs of Posterior Glenohumeral Instability. (2012) American Journal of Roentgenology. doi:10.2214/AJR.07.3849
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