Reverse Hill-Sachs and reverse Bankart lesions

Case contributed by Mandakini Siwach
Diagnosis certain

Presentation

Trauma from MVA. Right shoulder posterior dislocation. Ongoing pain not responding to treatment.

Patient Data

Age: 30 years
Gender: Male

There is focal depression along the anterosuperior aspect of the humeral head with underlying marrow edema, consistent with a reverse Hill-Sachs lesion. 

The glenoid appears unremarkable, with no obvious fracture or marrow edema.

There is a tear involving the posterior labrum between 7 o'clock and 12 o'clock position. This is in apparent continuity with a tear in the anterosuperior labrum extending to 3 o'clock position. The tear is in communication with a paralabral cyst on the anterosuperior aspect of the glenohumeral joint,  which is seen lateral to the coracoid process.

There is mild thickening and hyperintensity of the posterior band of the inferior glenohumeral ligament, suggesting a sprain, without any obvious avulsion.     

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