Orthopedic Injuries

🔍 Exploring Shoulder Dislocation and Associated Lesions 🔍 Shoulder dislocation isn't just about the ball and socket going awry; it's often accompanied by other significant lesions. Let’s dive into some key injuries that shoulder dislocations can bring: 🔸 Hill-Sachs Lesion: Imagine a dent on the back of the humeral head, caused by a collision with the shoulder socket. This damage can complicate shoulder stability and future dislocations. 🔸 Bankart Lesion: This injury occurs when the labrum, the rim of cartilage around the shoulder socket, tears away due to a dislocation. It’s a prime suspect in recurrent shoulder instability. 🔸 SLAP Lesion: Short for "Superior Labrum from Anterior to Posterior," this tear happens where the biceps tendon attaches to the labrum. It can cause pain and reduce the shoulder's range of motion. But that's not all! Other lesions that may accompany a dislocation include: ✅ Bony Bankart Lesion: A variation of the Bankart lesion where a fragment of the socket bone chips off. ✅ Rotator Cuff Tear: This involves the tearing of one or more of the shoulder's tendons, potentially leading to severe pain and dysfunction. ✅ HAGL Lesion: Humeral Avulsion of the Glenohumeral Ligament is where the ligaments anchoring the shoulder joint are torn away from the humerus. Understanding these lesions helps in diagnosing and planning effective treatments for shoulder injuries. Whether you're in healthcare, sports, or just curious, knowing these details can make all the difference! #physiotherapy #ShoulderInjury #Orthopedics #SportsMedicine #HealthAwareness #ShoulderDislocation #MedicalInsights

 Classic case of anterior shoulder dislocation with the following injuries; ·         Depression fracture noted on the posterior surface of the humeral head with marrow edema (Hill-Sachs fracture ). ·         Anterior inferior quadrant of the glenoid labrum is torn with elevation and avulsion of the adjacent periosteum. Signal of marrow edema noted at the anterior inferior aspect of the glenoid tubercle, no detectable glenoid fracture.  ·         Labral tear extends superiorly to involve the anterior superior and superior quadrants of the labrum with detachment from the underlying glenoid and fluid signal between superior surface of the labrum and bicipital anchor (bucket-handle tear). Biceps tendon attachment is intact. ·         Streaks of fluid noted at the Subscapularis tendons insertion suggestive of partial tear, with subtle foci of marrow edema on the lesser tuberosity. ·         Moderate to severe joint effusion noted with intermediate T1 signal intensity (hemarthrosis), joint capsule is distended posteriorly. ·         Inferior glenohumeral ligament shows focal interruption at its humeral attachment at the middle part of the ligament, the ligament is retracted (J sig). Anterior and posterior parts of the inferior glenohumeral ligament are intact. #mri #msk #mskmri #shoulder #shouldermri #orthopedic #radiology #dubaidoctors

⚪Anterior shoulder dislocation is where the top of your humerus (the “ball”) moves forwards and away from the glenoid cavity (the “socket”). It is by far the most common type of dislocation. Around 97% of shoulder dislocations are of this type. 📝The groups most commonly affected by anterior shoulder dislocation are: Young men due to sports injuries and traumatic incidents. Older adults from falls and frailty. 🌟Anterior dislocation usually occurs due to forceful external rotation while the arm is out. 🌟Reduction can be performed if possible with minimal complications. 📌Traumatic Anterior Shoulder Instability, also referred to as TUBS (Traumatic Unilateral dislocations with a Bankart lesion requiring Surgery), if recurrence rate is higher, traumatic shoulder injuries that generally occur as a result of an anterior force to the shoulder while its abducted and externally rotated and may lead to recurrent anterior shoulder instability. 📚✅Diagnosis is made clinically with the presence of positive anterior instability provocative tests and confirmed with MRI studies that may reveal labral and/or bony injuries of the glenoid and proximal humerus (Hill-Sachs lesion). ✅Treatment may be nonoperative or operative depending on the chronicity of symptoms, the presence of risk factors for recurrence, and the severity of labral and/or glenoid defects. In high-risk populations, surgery is often offered after a single dislocation event. #physiotherapy #sportsinjuries #orthopedics #musculoskeletal PT. Mahmoud Ragab Omar

Recurrent Shoulder Dislocation Explained One of the key concepts in shoulder instability is understanding on-track vs. off-track lesions—terms that can initially sound abstract to students and early-career orthopedic surgeons. In clinical terms: ✅ On-track → The Hill-Sachs defect is contained within the glenoid track (HSI < GT) ⚠️ Off-track → The defect extends beyond the glenoid articular track (HSI > GT), allowing engagement during movement 🧠 This concept is critical when planning surgical treatment: Bankart repair may be sufficient for on-track lesions. Off-track lesions often require additional procedures like the Latarjet or remplissage. 🎯 Proper imaging and glenoid bone loss measurement are crucial in guiding management and preventing failure of soft tissue repair. #Orthopedics #ShoulderInstability #HillSachs #GlenoidTrack #OrthopedicEducation #MedicalEducation #SportsMedicine #LinkedInLearning

🔍 What is it? 🔷A Hill-Sachs lesion is a compression fracture (dent) on the posterosuperior humeral head caused when it forcefully impacts the anterior glenoid rim during an anterior shoulder dislocation. ⸻ ⚙️ Mechanism (Why it happens) ➡️ Shoulder dislocates anteriorly ➡️ Humeral head slams into glenoid rim ➡️ Soft bone gets indented (compression fracture) ➡️ Leads to structural instability ⸻ ⚠️ Why it matters • Present in ~80% of recurrent dislocations • Key cause of chronic shoulder instability • Often occurs with: 🔴 Bankart lesion (labral tear) ⸻ 🚨 Symptoms • Shoulder pain • Feeling of slipping / instability • Clicking or catching sensation • ⚡ Apprehension in abduction + external rotation (throwing position) ⸻ 🧪 Diagnosis • X-ray → initial detection • MRI / CT → assess size + engagement • Important concept: 👉 “Engaging lesion” = higher risk of recurrence ⸻ 🛠️ Treatment 🟢 Small lesions (<20%) • Physiotherapy • Rotator cuff strengthening • Stability training 🟠 Moderate–Large lesions • Arthroscopic remplissage (fills defect) • Bone graft / reconstruction (severe cases) ⸻ 🔗 Common Associations • 🔴 Bankart lesion (labrum tear) • ⚡ Axillary nerve injury (rare but important) ⸻ 🧠 Clinical Pearl 👉 Hill-Sachs = humeral head injury 👉 Bankart = glenoid/labrum injury 💥 Together → high recurrence risk

🩻 Special Shoulder Projections | Complete X-Ray Positioning Guide 📌 Definition • Special shoulder projections are performed when routine AP and Scapular Y views are insufficient to evaluate fractures, dislocations, Bankart lesions, and Hill-Sachs lesions. 📋 Indications • Shoulder Dislocation • Proximal Humerus Fracture • Greater Tubercle Fracture • Glenoid Fracture • Recurrent Shoulder Instability • Bankart Lesion • Hill-Sachs Lesion 📷 1. Transthoracic Lateral (Lawrence Method) • Purpose: Trauma view when arm cannot be abducted; demonstrates proximal humerus & shoulder joint in lateral profile. • Patient Position: Erect, unaffected arm raised above head, injured arm by side. • CR: Horizontal beam through the Surgical Neck of Humerus. • SID: 100–180 cm (180 cm preferred to reduce magnification). • kVp: 70–80 • mAs: 8–12 • Grid: Required (Adults) 📷 2. Inferosuperior Axial (Lawrence Method) • Purpose: Demonstrates relationship of the humeral head with the glenoid cavity; excellent for anterior & posterior dislocations. • Patient Position: Supine, arm abducted 90° (only if tolerated). • CR: 25–30° medially through the axilla to the shoulder joint. • SID: 100 cm • kVp: 70–80 • mAs: 8–12 • Grid: Required (Adults) • Contraindication: Do not perform if the patient cannot abduct the arm. 📷 3. West Point Axillary View • Purpose: Detects Bankart lesions of the anterior glenoid rim. • Patient Position: Prone, shoulder over the edge of the table. • CR: 25° downward and 25° medially toward the axilla. • SID: 100 cm • kVp: 70–80 • mAs: 8–12 • Grid: Required (Adults) 📷 4. Stryker Notch View • Purpose: Demonstrates Hill-Sachs lesions on the posterolateral humeral head. • Patient Position: Supine, hand of affected side placed on top of the head (if tolerated). • CR: 10° cephalad toward the coracoid process. • SID: 100 cm • kVp: 70–80 • mAs: 8–12 • Grid: Required (Adults) 📷 5. Apical Oblique (Garth Method) • Purpose: Demonstrates glenoid rim fractures, Hill-Sachs lesions & shoulder instability. • Patient Position: Patient leans 45° toward the affected side. • CR: 45° caudad to the shoulder joint. • SID: 100 cm • kVp: 70–80 • mAs: 8–12 • Grid: Required (Adults) ⚠️ Trauma Modifications • Never force abduction or rotation of the injured shoulder. • If abduction is not possible, perform Transthoracic Lateral (Lawrence Method) or Scapular Y View. • Keep the patient in the most comfortable position. 🩺 Common Pathologies • Anterior Shoulder Dislocation • Posterior Shoulder Dislocation • Bankart Lesion • Hill-Sachs Lesion 📝 Includes exam-oriented MCQs with answers for quick revision. 📚 Follow @radiiodiagnosis for daily Radiology Positioning, Anatomy, Procedures, Case Discussions & Competitive Exam Preparation.

A recent patient of mine had a very heavy fall while skiing, landing hard on his shoulder. This resulted in a posterior dislocation. A rare injury, accounting for only about 10% of shoulder dislocations (most are anterior). What made this case more complex was the extent of the damage. Imaging showed: - A reverse bony Bankart injury, where part of the bone and cartilage at the back of the socket (glenoid) was chipped away. - A labral tear on the back of the shoulder. - A small fracture fragment in the joint. - A reverse Hill-Sachs–type injury. A dent at the front of the humeral head caused when the shoulder dislocated backwards and impacted. The MRI and CT scans clearly showed the difference between the injured and uninjured side, highlighting just how significant the structural loss was at the back of the socket. Cases like this require careful planning to restore stability and function, especially in younger, active patients. To watch the full breakdown of the imaging and injury, click here: https://lnkd.in/g9DVN3Ys #Orthopaedics #ShoulderInjury #SportsMedicine #PosteriorDislocation #OrthopaedicSurgery