Wk 4, Case 1 - Review

Patient History
24 year-old male with a history of right shoulder dislocation and pain.
Findings

ROTATOR CUFF: Contusion and interstitial microtearing of the supraspinatus and infraspinatus; no macrotear. Microtearing at the myotendinous junction of the supraspinatus. Normal teres minor. Normal subscapularis.

SUBACROMIAL/SUBDELTOID BURSA: Mild subacromial-subdeltoid peritendinitis.

MUSCLES (ROTATOR CUFF/DELTOID, TRAPEZIUS, PECTORALIS): No rotator cuff muscle atrophy, strain, or tear.

BICEPS TENDON: Normal long head biceps tendon, without dislocation or tear.

AC JOINT: Normal acromioclavicular joint without separation.

CORACOCLAVICULAR LIGAMENTS: Normal coracoclavicular ligaments without swelling or tear.

SUBACROMIAL ARCH/OUTLET: No subacromial arch stenosis or impingement.

SUBCORACOID ARCH: No subcoracoid arch narrowing or impingement.

GLENOHUMERAL JOINT: Normal glenoid and humeral head cartilage at the articular surfaces. Rupture of the inferior glenohumeral ligaments from the humerus with soft tissue swelling dissecting into the axilla. No avulsion fracture. The glenoid attachments are intact.

GLENOID LABRUM: No acute labral tear or paralabral cyst. Fissuring of the posterior-inferior glenoid labrum, chronic.

BONES: Mild osseous contusion of the humeral head adjacent to the supraspinatus insertion. Mild osseous contusion as a Hill-Sachs equivalent. No Bankart injury or glenoid bone loss.

SUBCUTANEOUS SOFT TISSUES: Normal without swelling or mass.

AXILLA: Soft tissue swelling dissecting from the glenohumeral joint. Normal neurovasculature. No lymphadenopathy.

Impressions
Humeral avulsion of the glenohumeral ligaments, HAGL.
Supraspinatus and infraspinatus contusion and interstitial microtearing. No communicating, surfacing or retracted rotator cuff tear.
Hill-Sachs equivalent without macrofracture. No Bankart labral or glenoid injury.
Mild subacromial-subdeltoid peritendinitis.