0:01

In honor of my father, who was in the trucking

0:03

business, who used some interesting language,

0:07

when he got angry, he would call somebody a GLOM.

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I never knew what that meant, but now I do.

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It stands for glenoid or glenolabral ovoid mass,

0:18

although I don't think that's what he meant.

0:20

What is, uh, what is a GLOM lesion on MRI?

0:25

Well, it's an anterior inferior or anterior

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labral tear that migrates superiorly.

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And starts to aggregate tissue around it, like synovial

0:35

tissue, or capsule, or the middle glenohumeral ligament.

0:38

So when we go down low, we know that the

0:41

anteroinferior labral ligamentous complex should be

0:44

at least as big as the posterior labrum, like this.

0:47

And should get bigger, it shouldn't be flat.

0:50

And as you go down, it should get blacker, and bigger.

0:54

It does get a little blacker, but not so black.

0:57

And then when we go all the way down, there's a defect.

1:00

Right there in the front of it.

1:02

So that defect, admittedly, is a little

1:04

amorphous, a little hard to discern.

1:06

Although, in the, in the typical anatomic situation, I

1:10

would like to see something that looks, you know, like this.

1:14

Especially in a younger, uh, individual.

1:18

Um, and this patient is moderately

1:20

muscular, not overly muscular.

1:22

Now let's scroll our way up.

1:25

And we see a portion of the labrum that's displaced

1:28

into the glenohumeral articulation, completely

1:31

detached, and another structure anterior to it.

1:34

And look at where we are.

1:36

We're above the equator of the humeral head.

1:39

For the definition of a glom lesion is a detached

1:43

piece of labrum All of it or some of it that

1:47

migrates superiorly and aggregates capsular

1:51

or glenohumeral ligament tissue around it.

1:54

And that is exactly what you're seeing here.

1:57

A piece of the labrum encased.

1:59

by capsular tissue in the mid to upper

2:03

portion of the shoulder with another piece of

2:06

labrum, unfortunately, that has detached and

2:10

migrated between the humerus and the glenoid.

2:13

And both of these could be involved

2:15

in functional instability or catching.

2:17

I believe this occurred, uh, in this

2:20

patient while picking up a child.

2:22

So it wasn't a collision, uh, type injury.

2:25

And these glom lesions Like Perthes lesions can

2:28

occur in micro instability events or less traumatic

2:33

events or severe acute collision type traumas.

2:37

The Glom lesion, the glenoid or glenolabral ovoid mass,

2:42

a piece of labrum that migrates superiorly aggregating

2:45

tissue around it to produce an anterior pseudomass.