Radiology Teaching Files > Case 2833802

previously visited HILL-SACHS DEFORMITY
Contributed by: Fritsch & Thompson, Radiologist, Diagnostic Radiology of Houston, Texas, USA.
Patient: 40 year old male
History: Status post "shoulder dislocation" persisting pain and instability.

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Findings: Internal rotation plain film (fig 1) shows smooth, shallow depression and sclerosis of the lateral aspect of humeral head. External rotation and "baby-arm" plain films show ill-defined subarticular sclerosis, not accounted for by superimposed anatomy. MR imaging clearly shows compression injury to the postero-lateral aspect of the humerus (low T1/hi fat-sat, T2 and PD signal changes).
Diagnosis: Hill-Sachs deformity of the posterolateral humeral head
Discussion: Most (over 95%) glenohumeral dislocation results in anterio-medial humeral displacement. Dislocation is often initiated from an abducted-externally rotated position, resulting in significant impact of the postero-lateral aspect of the humeral head against the glenoid. Compression injury to the humeral head has been referred to as the Hill-Sachs deformity or "hatchet" deformity. Associated injury to the cartilagenous and/or osseous portions of the glenoid are also common, as in this patient who also had a labral injury.

1. Greenspan: Orthopedic Imaging- a practical approach 4th ed.
2. Ref. Physician: Michael Mann, MD

Case Of the Week: 10/19/2005

MRI Case of the Week: 8/2/06

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Additional Details:

Case Number: 2833802Last Updated: 08-16-2006
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional Radiograph, MRExam Date: 09-28-2005Access Level: Readable by all users
Keywords: hill-sachs; hatchet deformity; shoulder dislocation; shoulder trauma

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