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Review Question - QID 314

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QID 314 (Type "314" in App Search)
A 19-year-old right hand dominant male high school wide receiver complains of recurrent right shoulder subluxation. Clinical examination is remarkable for a postive apprehension sign and a positive sulcus sign. A T2 coronal MRI is shown below in Figure A. What is the diagnosis?
  • A

Bankart lesion

7%

128/1861

SLAP tear

6%

117/1861

Rotator cuff tear

2%

38/1861

ALPSA lesion

5%

86/1861

HAGL lesion

80%

1482/1861

  • A

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The humeral avulsion of glenohumeral ligament (HAGL) is a rare cause of anterior shoulder instability. The prevalence among unstable shoulder is reported as 7-9%. The term HAGL was coined by Wolf in 1995. In 64 shoulders undergoing surgery for instability, they found 6 shoulders had HAGL lesions (9.3%), 11 shoulders with generalized capsular laxity (17.2%), and 47 shoulders with Bankart lesions (73.5%). Taylor found an even lower occurrence of HAGL in instability (only 1 of 67). The gold standard repair is by open repair although small case series of arthroscopic repairs have been described recently. Anterior labro-ligamentous periosteal sleeve avulsion (ALPSA) is when the IGHL complex, labrum, and periosteum are stripped and displaced medially and infereiorly on the scapular neck

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