MyPACS.net: Radiology Teaching Files > Case 4863090

previously visited POSTERIOR LABRAL TEAR
Contributed by: Fritsch & Thompson, Radiologist, Diagnostic Radiology of Houston, Texas, USA.
Patient: 17 year old male
History:
Varisty football player with painful limited range of motion after last game.  Coach and parents want to know should he play football next week. 
Images:[small]larger

Fig. 1: EXTERNAL ROTATION OF THE SHOULDER

Fig. 2: INTERNAL ROTATION OF THE SHOULDER

Fig. 3: AXILLARY VIEW OF THE SHOULDER

Fig. 4: GRE AXIAL IMAGE 12

Fig. 5: GRE AXIAL IMAGE 11

Fig. 6: GRE AXIAL IMAGE 10

Fig. 7: T2 CORONAL FATSAT - Note high intensity linear tear in poserior labral margin.
Findings:
X-RAY:
Alignment is unremarkable. Cortical margins and trabecular patterns are intact. Some lateral downsloping of the acromion is identified as a predisposing factor for impingement. Joint spacing is unremarkable. Soft tissues are unremarkable.

MRI:
There is a posterior labral tear with periosteal elevation and associated capsular derangement in the posterior aspect of the glenohumeral joint best depicted on axial T2 images #10, 11 & 12. This does extend to the posterior inferior margin of the glenoid fossa. The inferior glenohumeral ligament is intact. The remaining labrum does not show any abnormality. There is a small effusion in the glenohumeral joint. Biceps tendon anchor is intact. The position of the long head of the biceps tendon is adequate.  The rotator cuff does not show any tears. There is a small amount of fluid in the subdeltoid bursa. The AC joint is well maintained with a type I acromion. However, there is significant lateral downsloping of the acromion which effaces the rotator cuff. Clinical correlation advised for associated impingement syndrome. The osseous elements do not show any fractures or aggressive marrow lesions.


Diagnosis:
MRI:
POSTERIOR LABRAL TEAR WITH ASSOCIATED CAPSULITIS AND PERIOSTEAL ELEVATION .

X-RAY:
NEGATIVE EXAM.

Discussion: Related web sites:

http://www.mrprotocols.com/MRI/bone/shoulder/example_files/labral.htm

http://www.medscape.com/viewarticle/464852

http://www.steadman-hawkins.com/virtual/education/shoulder/inside_shoulder_popup/inside_shoulder_popup.html
References: REFERRING PHYSICIAN: DR. EDWIN KIEKE, DC
Comments:
No comments posted.
Additional Details:

Case Number: 4863090Last Updated: 09-12-2007
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional Radiograph, MRExam Date: 03-28-2006Access Level: Readable by all users
Keywords: shoulder, labral tear, periosteal elevation

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