Glenoid labral avulsion

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Recurrent shoulder dislocations - ? labral integrity.

Patient Data

Age: 22
Gender: Male
mri

There is a large bony deficiency of the anterior glenoid, extending from the 2 o'clock to 6 o'clock position. The bony deficiency measures *30%. The antero-inferior labrum can not be identified. There is associated capsular stripping and thickening extending approximately 13mm medially along the glenoid margin. Anterior subluxation of the humeral head is noted. There is a corresponding, broad, but shallow Hill-Sachs deformity measuring 28 x 3 mm. There is no underlying bone marrow edema, in keeping with old injury. A small 7 mm subchondral cyst is also noted. There is stripping of the posterior band of the IGHL from its humeral attachment but no discrete tear. No bony avulsion. The superior labrum is intact, with no SLAP lesion. A superior sublabral recess is noted. The long head of biceps tendon is intact. The AC joint is normal. The rotator cuff tendons are intact. No intra-articular fragments. Incidental bone island deep to the superior aspect of the glenoid cup.

Comment 1. Bony deficiency (*30%) of the anterior glenoid with large anterior capsular stripping (down to 6 oclock) and redundant IGHL anterior band. 2. Broad, shallow Hill-Sachs deformity 3. stripping of the posterior band of the IGHL at humerus.

mri

Estimation of labral deficiency.

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