Wk 5, Case 3 - Review

Patient History
17-year-old male with football injury 2 months ago presenting with pain and decreased range of motion. Concern for Bankart tear.

Findings
ROTATOR CUFF: Mild supraspinatus rotator cuff tendinopathy with a small focal concealed interstitial delamination “CID” seen on series 701, image 13. Infraspinatus, teres, subscapularis, and extra-articular biceps normal.

SUBACROMIAL/SUBDELTOID BURSA: Minimal swelling.

MUSCLES (ROTATOR CUFF/DELTOID, TRAPEZIUS, PECTORALIS): Muscular patient suggests weightlifting activity.

BICEPS TENDON: Biceps proper intact with superior labral tear undercutting the biceps labral anchor seen anterosuperiorly, series 701, images 12 and 13.

AC JOINT: Normal for age and gender.

CORACOCLAVICULAR LIGAMENTS: Normal.

SUBACROMIAL ARCH/OUTLET: Coracoacromial ligament thickening. Mild periligamentous swelling, series 701, image 14.

SUBCORACOID ARCH: Normal.

GLENOHUMERAL JOINT: Near-normal conformity. Slight posterior decentering suggests posterior microinstability.

GLENOID LABRUM: Anterosuperior, superior, posterosuperior, and posterior rim labral tear punctuated by labrocartilaginous rim tear or marginal crack producing a small posterior-inferior pouch. Findings are consistent with reverse Perthes or Kim’s lesion. SLAP lesion with posterior labral extension compatible with SLAP 8.

BONES: Slight flattening of the posterior glenoid cup.

SUBCUTANEOUS SOFT TISSUES: Normal.

AXILLA: Normal.

Impressions
SLAP 8 with posterior glenoid rim extension as a reverse Perthes or Kim’s lesion. Findings are consistent with posterior microinstability due to overuse, as in a weightlifter.