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Stay out of trouble with shoulder stabilization: Don’t miss the HAGL

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Anterior capsulolabral injury (Bankart lesion) is a common cause of anterior shoulder instability that is frequently treated with excellent outcomes. However, it is important not to miss associated pathology. Humeral avulsion of the glenohumeral ligament (HAGL), occurring in combination with a Bankart lesion, can present with similar findings to an isolated Bankart lesion, but if not recognized and treated will lead to recurrent instability.

 

Jonathan F. Dickens

 

Brett D. Owens

In a case example, a 21-year-old rugby player sustained multiple previous subluxation episodes without a formal dislocation event. His first subluxation was the result of a collision with his arm in a hyperabducted position. His primary complaint at the time of presentation was of a sensation of inferior instability, especially while running. His MRI with contrast showed a Bankart lesion and HAGL involving the anterior band.

To read the full Case Studies in Sports Medicine blog from Jonathan F. Dickens, MD, and Brett D. Owens, MD, click here.