Capsular lesions with glenohumeral ligament injuries in patients with primary shoulder dislocation: magnetic resonance imaging and magnetic resonance arthrography evaluation

S Liavaag, M G Stiris, S Svenningsen, M Enger, A H Pripp, J I Brox, S Liavaag, M G Stiris, S Svenningsen, M Enger, A H Pripp, J I Brox

Abstract

The glenohumeral ligaments are important structures for the stability of the shoulder. They are integrated parts of the capsule and are at risk to be injured in a traumatic shoulder dislocation. The aim was to examine the prevalence of capsular ligament lesions in the acute phase and at minimum 3 weeks' follow-up after first-time traumatic shoulder dislocation. Forty-two patients aged 16-40 years were included. All patients underwent computed tomography and magnetic resonance imaging (MRI) scans shortly after the injury and MR-arthrography (MRA) at follow-up. The median time from dislocation to MRI was 7 (range 2-14) days and to MRA 30 (range 21-54) days. We found capsular ligament lesions in 22 patients (52.4%) in the acute stage and in five patients (11.9%) at follow up. Nine patients (21.4%) had a humeral avulsion of the anterior glenohumeral ligament (HAGL lesion) on MRI. Three patients (7.1%) had this lesion at follow-up. The rate of HAGL lesions in the acute stage was higher than reported previously, but the prevalence at follow-up was in keeping with earlier published studies.

© 2011 John Wiley & Sons A/S.

Figures

Fig. 2
Fig. 2
A posterior anterior glenohumeral ligament (HAGL) lesion disappearing after 31 days. The figure shows the images from the shoulder of a 29-year-old male after primary traumatic anterior dislocation of the left shoulder. (a) Oblique coronal STIR (3000/37) 8 days after dislocation of the left shoulder reveals a posterior HAGL lesion. (b) Oblique coronal T1 fat sat (600/11) with intraarticular contrast medium obtained 31 days after the dislocation demonstrates full recovery.
Fig. 1
Fig. 1
An anterior humeral avulsion of the anterior glenohumeral ligament (HAGL) lesion disappearing after 3 weeks. The figure shows the images from the shoulder of a 27-year-old male, after primary traumatic anterior dislocation of the right shoulder. (a) Oblique coronal STIR (3000/37) 6 days after dislocation of the right shoulder demonstrates an anterior HAGL lesion (arrow). (b) Oblique coronal T1 fat sat (600/11) with intraarticular contrast medium 24 days after the dislocation reveals full recovery.

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