MyPACS.net: Radiology Teaching Files > Case 792665

never visited ALPSA LESION: ANTERIOR LABROLIGAMENTOUS PERIOSTEAL SLEEVE AVULSION
Contributed by: John Hunter, Radiologist, University of California, Davis, California, USA.
History: 20 y/o collegiate defensive back with acute injury to right shoulder.
Images:[small]larger

Fig. 1: 1COR

Fig. 2: 2COR

Fig. 3: 1AXHS

Fig. 4: 2AXHS

Fig. 5: 1AX

Fig. 6: SAG

Fig. 7: DIAG

Fig. 8: black arrows= Hill-Sachs lesion/large white arrows= torn capsule and inferior glenohumeral ligament/ small white arrows= avulsed labrum with attached periosteum

Fig. 9: 2CORARROW

Fig. 10: large white arrow= avulsed labrum/ small white arrows= attached periosteum

Fig. 11: large white arrow= subscapularis tendon/ small white arrows= torn labroligamentous complex
Diagnosis: ALPSA lesion: anterior labroligamentous periosteal sleeve avulsion.
Discussion:

In the Bankart lesion, the anterior cartilage labrum is detached and torn from the periosteum. In the ALPSA, the labral fragment remains attached to the periosteum of the scapular margin and can be tethered in this abnormal position, increasing the likelihood further medial displacement and of re-dislocation.

This patient has a history of previous dislocations and sustained an anterior dislocation the day before this examination. Note the Hill- Sachs fracture as well.

References: Source: John Hunter's MSK Teaching File: Shoulder Case 27
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Additional Details:

Case Number: 792665Last Updated: 10-20-2004
Anatomy: Skeletal System   Pathology: Trauma
Modality: MRExam Date: Access Level: Readable by all users

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