CASE

Shoulder – HAGL lesion

CASE HISTORY

Work related left shoulder injury. Resident where she worked jerked her left arm and she felt a tear in the proximal humerus. Mild swelling left shoulder to elbow. No surgeries.

TECHNICAL FACTORS

Long- and short-axis fat- and water-weighted images were performed. 

KEY IMAGES

This case has no key images.

CASE FINDINGS

  • No abnormal bone marrow signal to suggest acute fracture or bony contusion. Normal glenohumeral alignment. No hypertrophic osteoarthritic change at the acromioclavicular joint. Lateral downsloping of the acromion which has a curved undersurface. Mild narrowing of the lateral bony arch. 
  • Rotator cuff is intact without focal full thickness tears. Long head biceps tendon intact and seen within the bicipital groove. Glenoid labrum grossly intact. Redundancy of the inferior glenohumeral ligament with probable disruption at its humeral insertion with surrounding edema. (HAGL lesion). No edema at the humerus. No bony avulsion. No evidence for focal muscle injury or atrophy.

CASE CONCLUSION

  • Suspected ligamentous avulsion of the anteroinferior glenohumeral ligament from its humeral insertion without bony avulsion. (HAGL lesion).
  • Rotator cuff intact. 
  • Mild narrowing of the lateral bony arch.

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