Diagnosis Hill–Sachs lesion

mri of shoulder after dislocation hill–sachs lesion , labral bankart s lesion



hill sachs lesion post shoulder dislocation

imaging diagnosis conventionally begins plain film radiography. generally, ap radiographs of shoulder arm in internal rotation offer best yield while axillary views , ap radiographs external rotation tend obscure defect. however, pain , tenderness in injured joint make appropriate positioning difficult , in recent study of plain film x-ray hill–sachs lesions, sensitivity 20%. i.e. finding not visible on plain film x-ray 80% of time.

by contrast, studies have shown value of ultrasonography in diagnosing hill–sachs lesions. in population recurrent dislocation using findings @ surgery gold standard, sensitivity of 96% demonstrated. in second study of patients continuing shoulder instability after trauma, , using double contrast ct gold standard, sensitivity of on 95% demonstrated ultrasound. should borne in mind in both studies, patients having continuing problems after initial injury, , therefore presence of hill–sachs lesion more likely. nevertheless, ultrasonography, noninvasive , free radiation, offers important advantages.

mri has been shown highly reliable diagnosis of hill-sachs (and bankart) lesions. 1 study used challenging methodology. first of all, applied patients single, or first time, dislocation. such lesions smaller , therefore more difficult detect. second, 2 radiologists, blinded surgical outcome, reviewed mri findings, while 2 orthopedic surgeons, blinded mri findings, reviewed videotapes of arthroscopic procedures. coefficiency of agreement calculated mri , arthroscopic findings , there total agreement ( kappa = 1.0) hill-sachs , bankart lesions.