J Korean Soc Magn Reson Med.  2013 Mar;17(1):26-32. 10.13104/jksmrm.2013.17.1.26.

Hill-Sachs Lesion on MR Arthrography of the Shoulder: Relationship with Bankart Lesion on Arthroscopy and Frequency of Shoulder Dislocations

• Kim JN
• Lee MH
• Ahn JM

• KMID: 1426748
• DOI: http://doi.org/10.13104/jksmrm.2013.17.1.26

Abstract

PURPOSE
This study was performed to evaluate the presence and severity of Hill-Sachs (HS) lesions on MR arthrography (MRA) of shoulder in patients with Bankart lesions following anterior dislocation and to investigate their relationship with Bankart lesions and frequency of dislocations.
MATERIALS AND METHODS
86 MRA of shoulder were evaluated in patients with arthroscopic Bankart repairs following anterior dislocations. The largest surface length of HS lesion on MRA and extent of Bankart lesions on arthroscopy were measured. Relationships between length of HS lesions and extent of Bankart lesions and frequency of dislocations were assessed.
RESULTS
HS lesions were identified on MRA in 78 patients. The largest surface length of HS lesion ranged from 9.3 mm to 29.6 mm (mean, 18.8 mm). The extent of Bankart lesion ranged from one to six o'clock extent (mean, 4.25 o'clock extent). Three patients had single dislocation and the other 75 patients had recurrent dislocations (mean 24.5 times). The largest surface length of HS lesions was positively correlated with extent of Bankart lesions (p = 0.001, r = 0.37), but not with frequency of dislocation.
CONCLUSION
HS lesion was very common in patients with Bankart lesion. The severity of HS lesions was correlated with extent of Bankart lesions.

Keyword

Shoulder; MR arthrography; Trauma; Hill-Sachs lesion; Bankart lesion

MeSH Terms

Arthrography
Arthroscopy
Dislocations
Humans
Shoulder
Shoulder Dislocation

Figure

• 

  Fig. 1 Hill-Sachs lesion on MR arthrogram in a patient with antecedent anterior shoulder dislocation. A fat-saturated T1-weighted axial MR image at the level of the coracoid process shows a notched defect (arrow) (a) and flattening (arrow) (b) on posterolateral aspect of humeral head indicating Hill-Sachs lesion.

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  Fig. 2 Measurement of the largest surface length of Hill-Sachs lesion on MR arthrogram. On three contiguous fat-saturated T1-weighted axial MR images, the surface lengths of bony defect on posterolateral aspect of humeral head (dotted lines) are measured (a-c). Among them, the largest surface length of Hill-Sachs lesion (b) is recorded as the extent of Hill-Sachs lesion.

• 

  Fig. 3 Description of conventional clock-face in glenoid. A fat-saturated T1-weighted oblique coronal image shows a detachment of anteroinferior aspect of glenoid labrum (dotted line with arrow tips), indicating Bankart lesion. Bankart lesion is located at 2 to 6 o'clock direction on the basis of conventional clock-face description of the location of the glenoid labrum, the extent of Bankart lesion is 4 o'clock extent. Arrows indicates 12, 3, 6, 9 o'clock direction starting from the superior point with counterclockwise direction.

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  Fig. 4 Scatterplot graph about relationship between the largest surface length of Hill-Sachs lesions and the extent of Bankart lesions. Graph shows a positive correlation between the largest surface length of Hill-Sachs lesions on MR arthrograms (x-axis) and the extent of Bankart lesions at arthroscopy (y-axis). The Spearman's correlation coefficient is 0.37, p = 0.001.

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