eMedicine Specialties > Radiology > Musculoskeletal
Shoulder, Dislocations: Multimedia
Updated: Jul 31, 2009
Multimedia
 | Media file 1: Y-view radiograph of the right shoulder shows anterior dislocation of the humeral head relative to the glenoid fossa. |
 | Media file 2: Anteroposterior radiograph of the right shoulder shows anteroinferior glenohumeral dislocation. Impaction of the inferior glenoid causes the Hill-Sachs defect on the posterosuperior humeral head. |
 | Media file 3: Anteroposterior radiograph obtained after reduction of anterior dislocation. Residual fracture fragments are noted (arrows). |
 | Media file 4: Anteroposterior radiograph of the left shoulder shows posterior glenohumeral dislocation. Impaction of the humeral head on the posterior glenoid results in the reverse Hill-Sachs defect (trough sign) on the anterior aspect of the humeral head. Courtesy of Dr M. A. Png, Singapore General Hospital. |
 | Media file 5: Anteroposterior radiograph shows luxatio erecta, or inferior dislocation of the shoulder. The arm is abducted, elevated, and fixed. The humeral head is subcoracoid in position, with a parallel humeral shaft and a parallel scapular spine. An associated greater tuberosity fracture is present. |
 | Media file 6: Double-contrast axial computed tomography (CT) arthrogram of the left shoulder shows an undisplaced tear (arrows) of the anterior glenoid labrum. The patient had one episode of an anterior dislocation. |
 | Media file 7: Double-contrast axial computed tomography (CT) arthrogram of the right shoulder shows a deficient anterior glenoid labrum (arrows) and medial stripping of the anterior capsular attachment (arrowhead). The patient had a recurrent anterior dislocation. |
 | Media file 8: Double-contrast axial computed tomography (CT) arthrogram of the right shoulder shows a small, loose body (arrow) in the axillary recess. The patient had recurrent anterior dislocations. |
 | Media file 9: Double-contrast, reconstructed, 2-dimensional coronal computed tomography (CT) arthrogram of the right shoulder shows a large Hill-Sachs defect (arrow) in the humeral head. A full-thickness rotator cuff tear is present, evidenced by a large amount of air in the subacromial/subdeltoid bursa. The remnant end of the supraspinatus tendon is seen (arrowhead). |
 | Media file 10: Double-contrast axial computed tomography (CT) arthrogram of the left shoulder shows a bony Bankart glenoid fracture (arrows). The patient had one episode of an anterior dislocation. |
 | Media file 11: Axial, gradient-recalled echo T2*-weighted conventional magnetic resonance imaging (MRI) scan of the right shoulder shows a small, undisplaced tear (arrow) of the anterior labrum. The patient had one episode of an anterior dislocation. |
 | Media file 12: Coronal, spin-echo T1-weighted conventional magnetic resonance imaging (MRI) scan of the left shoulder shows a large Hill-Sachs defect (arrows) in the superolateral humeral head. The patient had one episode of an anterior dislocation. |
 | Media file 13: Coronal, fast spin-echo T2-weighted conventional magnetic resonance imaging (MRI) scan of the left shoulder shows a large Hill-Sachs defect (arrows) in the superolateral humeral head (same patient as in Image 11). Surrounding bone marrow edema is shown. Fluid is present in the subacromial/subdeltoid bursa (arrowheads), indicative of a full-thickness rotator cuff tear. The patient had one episode of an anterior dislocation. |
 | Media file 14: Axial, spin-echo T1-weighted magnetic resonance arthrogram of the left shoulder shows a deficient anterior labrum (arrows) and medial stripping of the anterior capsular attachment (arrowheads). The patient had recurrent anterior dislocations. |
 | Media file 15: Axial, fat-suppressed, spin-echo T1-weighted magnetic resonance arthrogram of the right shoulder shows an undisplaced tear (arrow) of the anterior glenoid labrum. Part of the middle glenohumeral ligament is shown (arrowhead). The patient had one episode of anterior dislocation. |
 | Media file 16: Axial, spin-echo T1-weighted magnetic resonance arthrogram of the right shoulder shows an undisplaced tear (arrow) of the anterior glenoid labrum, which remains attached to the inferior glenohumeral ligament (arrowhead). The patient had recurrent anterior dislocations. |
 | Media file 17: Axial, spin-echo T1-weighted magnetic resonance arthrogram of the right shoulder shows an anterior labroligamentous periosteal sleeve avulsion lesion (arrows), seen as a rolled-up mass anterior to the neck of the scapula. The patient had recurrent anterior dislocations. |
 | Media file 18: Axial, spin-echo T1-weighted magnetic resonance arthrogram of the left shoulder shows a Perthes lesion (arrows). The anterior labrum is avulsed together with the intact periosteum of the scapula. The adjacent middle glenohumeral ligament (arrowheads) is shown. The patient had one episode of an anterior dislocation. |
 | Media file 19: Axial, fat-suppressed, T1 shoulder magnetic resonance arthrogram reveals a chondral defect (arrow) in the anterior glenoid, which is filled with contrast material. The hyaline cartilage shows decreased signal intensity (arrowhead). The anterior labrum is in its normal location. Courtesy of Dr W. R. Reinus, Mallinckrodt Institute of Radiology, St Louis, Mo. |
 | Media file 20: Coronal, fat-suppressed, spin-echo T1-weighted magnetic resonance arthrogram image of the right shoulder shows a loose body (arrow) in the axillary recess. The patient had a previous dislocation. |
 | Media file 21: Axial, spin-echo T1-weighted magnetic resonance arthrogram of the right shoulder shows tear of the posterior glenoid labrum (arrow) and a reverse Hill-Sachs defect (arrowhead). Patient had previous posterior dislocation. |
More on Shoulder, Dislocations |
| Overview: Shoulder, Dislocations |
| Imaging: Shoulder, Dislocations |
| Follow-up: Shoulder, Dislocations |
 Multimedia: Shoulder, Dislocations |
| References |
| Further Reading |
| « Previous Page |
References
Ng AW, Chu CM, Lo WN, Lai YM, Kam CK. Assessment of capsular laxity in patients with recurrent anterior shoulder dislocation using MRI. AJR Am J Roentgenol. Jun 2009;192(6):1690-5. [Medline].
Griffith JF, Antonio GE, Yung PS, Wong EM, Yu AB, Ahuja AT, et al. Prevalence, pattern, and spectrum of glenoid bone loss in anterior shoulder dislocation: CT analysis of 218 patients. AJR Am J Roentgenol. May 2008;190(5):1247-54. [Medline].
Saupe N, White LM, Bleakney R, Schweitzer ME, Recht MP, Jost B, et al. Acute traumatic posterior shoulder dislocation: MR findings. Radiology. Jul 2008;248(1):185-93. [Medline].
Murray PJ, Shaffer BS. Clinical update: MR imaging of the shoulder. Sports Med Arthrosc. Mar 2009;17(1):40-8. [Medline].
Magee T. 3-T MRI of the shoulder: is MR arthrography necessary?. AJR Am J Roentgenol. Jan 2009;192(1):86-92. [Medline].
Lecouvet FE, Simoni P, Koutaïssoff S, Vande Berg BC, Malghem J, Dubuc JE. Multidetector spiral CT arthrography of the shoulder. Clinical applications and limits, with MR arthrography and arthroscopic correlations. Eur J Radiol. Oct 2008;68(1):120-36. [Medline].
Chandnani VP, Yeager TD, DeBerardino T, et al. Glenoid labral tears: prospective evaluation with MRI imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol. Dec 1993;161(6):1229-35. [Medline].
Cvitanic O, Tirman PF, Feller JF, et al. Using abduction and external rotation of the shoulder to increase the sensitivity of MR arthrography in revealing tears of the anterior glenoid labrum. AJR Am J Roentgenol. Sep 1997;169(3):837-44. [Medline].
De Maeseneer M, Van Roy F, Lenchik L, et al. CT and MR arthrography of the normal and pathologic anterosuperior labrum and labral-bicipital complex. Radiographics. Oct 2000;20 Spec No:S67-81. [Medline].
Grainger AJ, Elliott JM, Campbell RS, et al. Direct MR arthrography: a review of current use. Clin Radiol. Mar 2000;55(3):163-76. [Medline].
Hottya GA, Tirman PF, Bost FW, et al. Tear of the posterior shoulder stabilizers after posterior dislocation: MR imaging and MR arthrographic findings with arthroscopic correlation. AJR Am J Roentgenol. Sep 1998;171(3):763-8. [Medline].
Palmer WE, Brown JH, Rosenthal DI. Labral-ligamentous complex of the shoulder: evaluation with MR arthrography. Radiology. Mar 1994;190(3):645-51. [Medline].
Palmer WE, Caslowitz PL, Chew FS. MR arthrography of the shoulder: normal intraarticular structures and common abnormalities. AJR Am J Roentgenol. Jan 1995;164(1):141-6. [Medline].
Peh WC, Cassar-Pullicino VN. Magnetic resonance arthrography: current status. Clin Radiol. Sep 1999;54(9):575-87. [Medline].
Roger B, Skaf A, Hooper AW, et al. Imaging findings in the dominant shoulder of throwing athletes: comparison of radiography, arthrography, CT arthrography, and MR arthrography with arthroscopic correlation. AJR Am J Roentgenol. May 1999;172(5):1371-80. [Medline].
Smith DK, Chopp TM, Aufdemorte TB, et al. Sublabral recess of the superior glenoid labrum: study of cadavers with conventional nonenhanced MR imaging, MR arthrography, anatomic dissection, and limited histologic examination. Radiology. Oct 1996;201(1):251-6. [Medline].
Stoller DW. MR arthrography of the glenohumeral joint. Radiol Clin North Am. Jan 1997;35(1):97-116. [Medline].
Willemsen UF, Wiedemann E, Brunner U, et al. Prospective evaluation of MR arthrography performed with high-volume intraarticular saline enhancement in patients with recurrent anterior dislocations of the shoulder. AJR Am J Roentgenol. Jan 1998;170(1):79-84. [Medline].
Garneau RA, Renfrew DL, Moore TE, et al. Glenoid labrum: evaluation with MR imaging. Radiology. May 1991;179(2):519-22. [Medline].
Gusmer PB, Potter HG, Schatz JA, et al. Labral injuries: accuracy of detection with unenhanced MR imaging of the shoulder. Radiology. Aug 1996;200(2):519-24. [Medline].
Jahnke AH Jr, Petersen SA, Neumann C, et al. A prospective comparison of computerized arthrotomography and magnetic resonance imaging of the glenohumeral joint. Am J Sports Med. Nov-Dec 1992;20(6):695-700; discussion 700-1. [Medline].
Kursunoglu-Brahme S, Resnick D. Magnetic resonance imaging of the shoulder. Radiol Clin North Am. Sep 1990;28(5):941-54. [Medline].
Legan JM, Burkhard TK, Goff WB, et al. Tears of the glenoid labrum: MR imaging of 88 arthroscopically confirmed cases. Radiology. Apr 1991;179(1):241-6. [Medline].
Neumann CH, Petersen SA, Jahnke AH. MR imaging of the labral-capsular complex: normal variations. AJR Am J Roentgenol. Nov 1991;157(5):1015-21. [Medline].
Rafii M, Firooznia H, Golimbu C. MR imaging of glenohumeral instability. Magn Reson Imaging Clin N Am. Nov 1997;5(4):787-809. [Medline].
Rafii M, Minkoff J. Advanced arthrography of the shoulder with CT and MR imaging. Radiol Clin North Am. Jul 1998;36(4):609-33. [Medline].
Seeger LL, Yao L, Gold RH. Diagnosis of glenoid labral tears: a comparison between magnetic resonance imaging and clinical examinations. Am J Sports Med. Jan-Feb 1997;25(1):141-4. [Medline].
Peh WC, Campbell C, Kelly IG, et al. The role of computerized tomography in shoulder arthrography. J R Coll Surg Edinb. Jun 1994;39(3):190-5. [Medline].
Rafii M, Firooznia H, Bonamo JJ, et al. Athlete shoulder injuries: CT arthrographic findings. Radiology. Feb 1987;162(2):559-64. [Medline].
Rafii M, Minkoff J, Bonamo J, et al. Computed tomography (CT) arthrography of shoulder instabilities in athletes. Am J Sports Med. Jul-Aug 1988;16(4):352-61. [Medline].
Singson RD, Feldman F, Bigliani L. CT arthrographic patterns in recurrent glenohumeral instability. AJR Am J Roentgenol. Oct 1987;149(4):749-53. [Medline].
Altchek DW, Warren RF, Wickiewicz TL, et al. Arthroscopic labral debridement. A three-year follow-up study. Am J Sports Med. Nov-Dec 1992;20(6):702-6. [Medline].
Beltran J, Bencardino J, Mellado J, et al. MR arthrography of the shoulder: variants and pitfalls. Radiographics. Nov-Dec 1997;17(6):1403-12; discussion 1412-5. [Medline].
Cetik O, Uslu M, Ozsar BK. The relationship between Hill-Sachs lesion and recurrent anterior shoulder dislocation. Acta Orthop Belg. Apr 2007;73(2):175-8. [Medline].
Garth WP Jr, Allman FL Jr, Armstrong WS. Occult anterior subluxations of the shoulder in noncontact sports. Am J Sports Med. Nov-Dec 1987;15(6):579-85. [Medline].
Glasgow SG, Bruce RA, Yacobucci GN, et al. Arthroscopic resection of glenoid labral tears in the athlete: a report of 29 cases. Arthroscopy. 1992;8(1):48-54. [Medline].
Jones KJ, Wiesel B, Ganley TJ, et al. Functional outcomes of early arthroscopic bankart repair in adolescents aged 11 to 18 years. J Pediatr Orthop. Mar 2007;27(2):209-13. [Medline].
Levy O, Matthews T, Even T. The "purse-string" technique: an arthroscopic technique for stabilization of anteroinferior instability of the shoulder with early and medium-term results. Arthroscopy. Jan 2007;23(1):57-64. [Medline].
Matsen FA, Harryman DT, Sidles JA. Mechanics of glenohumeral instability. Clin Sports Med. Oct 1991;10(4):783-8. [Medline].
Mizuno K, Hirohata K. Diagnosis of recurrent traumatic anterior subluxation of the shoulder. Clin Orthop. Oct 1983;(179):160-7. [Medline].
O'Connell PW, Nuber GW, Mileski RA, et al. The contribution of the glenohumeral ligaments to anterior stability of the shoulder joint. Am J Sports Med. Nov-Dec 1990;18(6):579-84. [Medline].
Pollock RG, Bigliani LU. Glenohumeral instability: evaluation and treatment. J Am Acad Orthop Surg. Oct 1993;1(1):24-32. [Medline].
Rowe CR, Zarins B. Recurrent transient subluxation of the shoulder. J Bone Joint Surg Am. Jul 1981;63(6):863-72. [Medline].
Tijmes J, Loyd HM, Tullos HS. Arthrography in acute shoulder dislocations. South Med J. May 1979;72(5):564-7. [Medline].
Tirman PF, Feller JF, Janzen DL, et al. Association of glenoid labral cysts with labral tears and glenohumeral instability: radiologic findings and clinical significance. Radiology. Mar 1994;190(3):653-8. [Medline].
Turkel SJ, Panio MW, Marshall JL, et al. Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint. J Bone Joint Surg Am. Oct 1981;63(8):1208-17. [Medline].
Warner JJ, McMahon PJ. The role of the long head of the biceps brachii in superior stability of the glenohumeral joint. J Bone Joint Surg Am. Mar 1995;77(3):366-72. [Medline].
Zlatkin MB, Bjorkengren AG, Gylys-Morin V, et al. Cross-sectional imaging of the capsular mechanism of the glenohumeral joint. AJR Am J Roentgenol. Jan 1988;150(1):151-8. [Medline].
Further Reading
Related eMedicine topics
Arthrocentesis, Shoulder
Joint Reduction, Shoulder Dislocation, Anterior
Joint Reduction, Shoulder Dislocation, Inferior
Joint Reduction, Shoulder Dislocation, Posterior
Shoulder Dislocations (Orthopedic Surgery)
Clinical guidelines
ACR Appropriateness Criteria® shoulder trauma. American College of Radiology - Medical Specialty Society. 1995 (revised 2005). 6 pages. NGC:004632
Clinical studies
Does Immobilization of the Shoulder in External Rotation Reduce the Recurrence Rate of Shoulder Dislocation?
Immobilization in External Rotation After First Time Anterior Shoulder Dislocation
Non-operative Versus Operative Treatment of Acute Acromioclavicular Joint Dislocation
Keywords
shoulder dislocation, glenohumeral instability, atraumatic shoulder dislocation, congenital shoulder laxity, macrotraumatic shoulder dislocation, microtraumatic shoulder dislocation, recurrent shoulder dislocation, Bankart lesion, atraumatic type with multidirectional and bilateral instability, AMBRI, glenohumeral ligaments, anterior shoulder dislocations, posterior shoulder dislocations, anterior labroligamentous periosteal sleeve avulsion, ALPSA, humeral avulsions, glenoid labral articular disruption, GLAD, bony humeral avulsion of the glenohumeral ligament, BHAGL, Perthes lesion, luxatio erecta, inferior shoulder dislocation
