15-year-old male fell on outstretched hand

Case History

Status post anterior dislocation. Tender to touch.

Technical Factors

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

Case Findings

Microtrabecular impaction contour posterior humeral head. 2 to 3+ joint effusion without bodies.
AC joint:
- Inferior subluxation of the acromion with horizontal appearance. Normal thickness of the coracoacromial ligament. No distention of the subacromion bursa.
Rotator cuff:
- Intact. Normal signal.
Biceps/anchor:
- Intact.
Anterior/inferior labral tear with periosteal stripping soft tissue Bankart with sub-millimeter pseudocysts. No osseous Bankart.
Coracoid arch:
- Coracohumeral ligament normal. Normal signal within the surrounding muscles apart from nominal swelling along the deep fibers inferior subscapularis. No compressive neuropathy or mass.

Case Conclusion

Microtrabecular Hill-Sachs fracture with large soft tissue anteroinferoaxillary Bankart. No bony Bankart. Anterior/inferior labral tear well shown. Associated nominal swelling of the IGHL. Suspected microseparation/avulsion of MGHL.
Normal AC joint. Nonunited anterior acromion.

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