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Humeral Avulsion of the Posterior Band of the Inferior Glenohumeral Ligament: MR Arthrography and Clinical Correlation in 17 Patients

¹ Department of Radiology, UCSD and VAHCS, 3350 La Jolla Village Dr., La Jolla, CA 92161.
² La Jolla Radiology, 8400 Miramar Rd., Ste. 200, San Diego, CA 92123.
³ Childrens' Hospital and Health Center, 3020 Childrens' Way, San Diego, CA 92123.

View larger version (156K): [in a new window]   Fig. 1A. —48-year-old female yoga instructor with long-standing shoulder pain and multidirectional instability at physical examination. Radiographic image obtained after arthrography with patient's arm in external rotation shows abnormal distribution of contrast material within axillary pouch, with contrast material (arrowheads) extending distally along humeral shaft.

View larger version (173K): [in a new window]   Fig. 1B. —48-year-old female yoga instructor with long-standing shoulder pain and multidirectional instability at physical examination. Coronal oblique fat-saturated fast spin-echo T1-weighted MR arthrogram (TR/TE, 900/12) shows discontinuous retracted fibers (straight arrow) of posterior band of inferior glenohumeral ligament and abnormal distribution of contrast material (curved arrow), which extends distally along humeral shaft.

View larger version (192K): [in a new window]   Fig. 2. —15-year-old female competitive high school volleyball player with multidirectional instability at physical examination. Coronal oblique fat-saturated fast spin-echo T1-weighted MR arthrogram (TR/TE, 900/14) shows discontinuous retracted fibers (straight arrow) of posterior band of inferior glenohumeral ligament and abnormal distribution of contrast material (curved arrow), which extends distally along humeral shaft.

View larger version (136K): [in a new window]   Fig. 3A. —Fat-saturated fast spin-echo MR arthrograms of 60-year-old man with chronic shoulder pain and no evidence of instability at physical examination. Axial T1-weighted image (TR/TE, 500/15) shows medial attachment (arrow) of anterior capsule compared with glenoid labral junction.

View larger version (113K): [in a new window]   Fig. 3B. —Fat-saturated fast spin-echo MR arthrograms of 60-year-old man with chronic shoulder pain and no evidence of instability at physical examination. Coronal oblique T1-weighted image (500/15) shows retracted fibers (arrowhead) of posterior band of inferior glenohumeral ligament and abnormal distribution of contrast material (arrow), which extends down humeral shaft.

View larger version (104K): [in a new window]   Fig. 3C. —Fat-saturated fast spin-echo MR arthrograms of 60-year-old man with chronic shoulder pain and no evidence of instability at physical examination. Sagittal T1-weighted image (500/12) of anterior aspect of joint shown by biceps tendon at its extra- and intraarticular junction (arrowhead) shows abnormal extension of contrast material (arrow) down humeral shaft.

View larger version (168K): [in a new window]   Fig. 4A. —Fat-saturated fast spin-echo MR arthrograms of 27-year-old male professional baseball player with chronic shoulder pain and multidirectional instability at physical examination. Axial T1-weighted image (TR/TE, 400/12) shows medial attachment (arrow) of posterior superior capsule to glenoid.

View larger version (176K): [in a new window]   Fig. 4B. —Fat-saturated fast spin-echo MR arthrograms of 27-year-old male professional baseball player with chronic shoulder pain and multidirectional instability at physical examination. Coronal oblique T1-weighted image (400/12) shows discontinuity of fibers (straight arrow) of posterior band of inferior glenohumeral ligament and abnormal extension of contrast material (curved arrow) down humeral shaft.

View larger version (211K): [in a new window]   Fig. 5A. —Fat-saturated fast spin-echo MR arthrograms of 31-year-old man with history of fall on outstretched hand 8 weeks before imaging. Axial T1-weighted image (TR/TE, 450/12) shows abnormal morphology of anterior inferior labrum with associated fibrous scar (curved arrow) that is consistent with previous Bankart lesion. Incidental note is made of contrast material (straight arrow) within subdeltoid bursa from extraarticular injection.

View larger version (181K): [in a new window]   Fig. 5B. —Fat-saturated fast spin-echo MR arthrograms of 31-year-old man with history of fall on outstretched hand 8 weeks before imaging. Coronal oblique T1-weighted image (450/12) shows retracted discontinuous fibers of posterior band of inferior glenohumeral ligament (straight white arrow) and abnormal distribution of contrast material (curved white arrow) along distal humeral shaft due to ligamentous insufficiency. Contrast material (black arrow) can also be seen in subdeltoid bursa.

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