21-year-old male pitcher complains of decreased range of motion
Pain with decreased range of motion. Injured playing baseball.
Long- and short-axis fat- and water-weighted images were performed.
- Skeletal: Mild-moderate osseous edema as sequela of internal impingement superolateral humeral head. No Hill-Sachs fracture. Nominal swelling along the superior margin of the posterior superior labrum related to cocking mechanism.
- Acromioclavicular Joint: Normal. Horizontal acromion. No bursal inflammation. Incidental small cyst at the anterior superior distal clavicle best shown in short-axis.
- Rotator Cuff: No full thickness tear. Mild intrinsic signal hyperintensity tendinosis involving the distal fibers supraspinatus and infraspinatus. Teres minor intact. No subscapularis tear.
- Biceps/Labrum: Preserved signal intensity within the biceps tendon and anchor. Inferior 6 o’clock position labrocapsular swelling stripping injury with periosteal elevation. No osseous Bankart. No HAGL lesion. Swelling marginates the inferior- medial periosteal and anterior inferior capsular portions of the IGHL.
- Coracoid Arch: No anterior arch stenosis. No spurring at the medial or lateral wall of the biceps groove.
- Joint Space: Normal fluid signal within the glenohumeral joint. No active capsulitis.
- Other Soft Tissue/Marrow: No muscular mass pathologic osseous lesion or evidence of entrapment neuropathy.
- Muscles: Muscles are normal in size and signal intensity.
- Dominant labral ligamentous low grade partial tear axillary 6 o’clock position of the IGHL. Should shoulder pain not resolve dedicated MR arthrogram would be useful for subsequent analysis. Imaging findings are consistent with axillary ligamentous shoulder sprain syndrome.
- Impaction pseudocyst as sequela of internal impingement seen with cocking in overhead athletes.
- No macrofracture. No osseous glenoid injury.