55-year-old female pain in shoulder extending to elbow after arm was jerked

Case
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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.

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

  • 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.
  • 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.