Presentation
Recurrent shoulder dislocation. Shoulder pain. Past history of trauma.
Patient Data
There is wedge-shaped defect noted in the posterolateral humeral head. It measures 1.8 x 0.9 cm (Length x Width). No adjacent marrow edema noted. Features suggestive of Hill-Sachs lesion.
There is detached anteroinferior labrum (3 to 6 o clock position) associated with glenoid rim fracture, suggestive of osseous Bankart lesion. No adjacent marrow edema noted.
Type II acromion configuration with lateral down slopping and acromioclavicular osteoarthritis noted. Secondary impingement of the supraspinatus tendon with tendinosis seen.
Supraspinatus tendon partial-thickness articular surface tear seen.
Subacromial - subdeltoid bursitis. Subcoracoid bursitis.
Small volume glenohumeral joint effusion.
The greater tuberosity shows mild sclerosis with cortical irregularity.
The Hill-Sachs lesion involves approximately 10% of the humeral head surface.
The osseous Bankart lesion shows approximately 6% glenoid bone loss.
Case Discussion
Hill-Sachs defect with bony or soft Bankart lesion is a common and straightforward entity.
Important reporting points for radiologist are:
- quantification of the Hill-Sachs defect is crucial (length x breadth) and the percentage of humeral surface involved.
- similar percentage quantification should be followed for glenoid bone loss while describing bony Bankart lesions.
Special thanks Dr HT Gururaj
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