Prevalence of HAGL lesions and associated abnormalities on shoulder MR examination

    Authors

    T. Magee

    Comments

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    Abbreviated Journal Title

    Skeletal Radiol.

    Keywords

    Shoulder; MR; Injury; HAGL; HUMERAL AVULSION; GLENOHUMERAL LIGAMENT; INSTABILITY; DIAGNOSIS; Orthopedics; Radiology, Nuclear Medicine & Medical Imaging

    Abstract

    Objective Humeral avulsion of the glenohumeral ligament (HAGL) is an uncommon shoulder injury. We report the prevalence of HAGL lesions and other associated shoulder injuries in a large series of shoulder MR examinations. All results were correlated with surgery. MR reports of 1,000 consecutive conventional shoulder MR exams performed on patients with shoulder pain were reviewed in our information system for the word HAGL. A total of 743 patients went on to surgery. There were 23 HAGL lesions reported at surgery. Those 23 examinations were reviewed retrospectively in consensus by two musculoskeletal radiologists. Scans were assessed for HAGL lesions, full or partial thickness supraspinatus, infraspinatus or subscapularis tendon tears, superior labral anterior posterior (SLAP) tears, anterior or posterior labral tears, and Hill-Sachs lesions. All 23 patients had HAGL lesions at surgery. Sixteen HAGL lesions were seen on prospective MR reading and 17 HAGL lesions were seen on retrospective MR consensus reading. Six HAGL lesions were not seen on retrospective consensus reading. Sixteen patients had Hill-Sachs deformities, ten had subscapularis tendon tears, five had supraspinatus tendon tears, six had superior labral tearing, and six had anterior labral tears. The above findings were confirmed on arthroscopy. In this series, there was a 1.6 % prevalence on all MR examinations, and prevalence of 2.1 % seen on MR examination for those who went to surgery. Common injuries associated with HAGL lesions are Hill-Sachs deformities and subscapularis tendon tears. Anterior labral tears were seen in only six cases despite Hill-Sachs deformities in 16 patients. In patients with Hill-Sachs deformities without anterior labral tears, one must carefully assess for the presence of a HAGL lesion.

    Journal Title

    Skeletal Radiology

    Volume

    43

    Issue/Number

    3

    Publication Date

    1-1-2014

    Document Type

    Article

    Language

    English

    First Page

    307

    Last Page

    313

    WOS Identifier

    WOS:000330622300006

    ISSN

    0364-2348

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