SHOULDER JOINT LIGAMENTS & CAPSULE-RADIOLOGY.pptx

LIGAMENTS AND CAPSULE OF SHOULDER JOINT

1. MRI SHOUDER – Ligaments & Capsule DR. JUSTIN JAMES

2. Pre test Identify the ighl Identify the mghl Identify the shgl identify coraco humeral ligament

3. The glenohumeral ligaments thickenings of the glenohumeral joint capsule passive stabilizers of the joint

4. SGHL

5. MGHL

6. IGHL

7. Spiral glenohumeral ligament / fasciculus obliquus from the infraglenoid tubercle and triceps tendon to the lesser tubercle shares insertion with the subscapularis tendon consistently demonstrated on MR arthrography

8. Humeral avulsion of the glenohumeral ligament (HAGL) Avulsion of the inferior glenohumeral ligament (IGHL) from its humeral insertion. It can be associated with a bony avulsion fracture in which case it is referred to as bony humeral avulsion of the glenohumeral ligament (BHAGL lesion) young men engaged in contact sports anterior shoulder dislocation due to forced hyperabduction and external rotation of the arm West Point classification of humeral avulsion of the glenohumeral ligament (HAGL)

9. CORACO-HUMERAL LIGAMENT

10. SURROUNDING LIGAMENTS

11. Related pathology humeral avulsion of the glenohumeral ligament (HAGL) bony humeral avulsion of the glenohumeral ligament (BHAGL lesion) glenoid avulsion of the glenohumeral ligament (GAGL) Bennett lesion

12. Associations bony avulsion from the medial cortex of the humeral neck, and when combined with a Bankart lesion are often termed a “floating” inferior glenohumeral ligament other findings associated with anterior shoulder dislocation are found in ~80% of cases including: subscapularis tear Hill-Sachs defect Bankart lesion and/or anterior labral injuries MRI: Typical findings include: avulsion of the IGHL from the proximal humerus retraction of the IGHL (so-called J sign): the normal U-shaped inferior glenohumeral recess is disrupted 2

13. Glenoid avulsion of the glenohumeral ligament avulsion fracture is of the glenoid attachment of the inferior glenohumeral ligament with or without disruption of the inferior labrum. Radiographic features: On coronal oblique glenohumeral arthrography "reverse J sign".

14. Bennett lesions of the shoulder / thrower's exostosis mineralization of the posterior band of the inferior glenohumeral ligament. Epidemiology: overhead throwing athletes. Associations: with posterior labral tears, posterior undersurface rotator cuff tear, and posterior subluxation of the humeral head. Clinical presentation: pain during the cocking and follow-through phases of throwing. tenderness of the posterior glenoid on palpation. Radiographic features Plain radiograph - CT or axillary view x-ray of the shoulder - a curvilinear extra-articular calcification along the posteroinferior rim of the osseous glenoid near the attachment of the posterior band of the inferior glenohumeral ligament MRI: edema within the ossification or around the capsule may suggest acute pain or injury

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