Learning objectives
The aim of this presentation is to discuss the stabilizers of the glenohumeral joint and to review the pathophysiology of shoulder dislocation.
We also present the concepts of Bipolar Bone Loss and Glenoid Tracking in this poster with details of radiological methods of evaluation and their implications in patient management.
Background
GENERAL ANATOMY: (Fig. 1)
The glenohumeral joint (GHJ) is the articulation between the glenoid fossa (GF) of the scapula and the head of the humerus (HH).
The GF is shallow,
thus lending an increased range of motion while providing minimal stability.
The GF is lined by a fibrocartilage,
the glenoid labrum,
which to a certain degree,
increases the depth of the fossa.
.
These osseous structures are surrounded by a fibrous network known as the glenohumeral capsule.
Thickenings of the capsule are known as the...
Imaging findings OR Procedure Details
RATIONALE OF REPAIR:
To achieve intrinsic stability,
the anteroinferior glenoid labrum and the glenoid bone distribute forces across the glenolabral complex when subjected to compressive loads.
With progressive labral and bone loss,
the articular contact is reduced which in turn increases the pressure across the joint when subjected to stress.
.
As a result,
an isolated soft tissue / Bankart repair,
without simultaneous bone graft,
in the setting of shoulder dislocations with glenoid bone loss,
will lead to an overload of forces at the overload...
Conclusion
Bipolar Bone Loss is common in shoulder dislocations.
The knowledge of the functional anatomy of the shoulder joint and evaluation of potential instability is critical in the choice of surgical treatment for the patient.
References
Gyftopoulos S,
Beltran LS,
Bookman J,
Rokito A.
MRI Evaluation of Bipolar Bone Loss Using the On-Track Off-Track Method: A Feasibility Study.
American Journal of Roentgenology 2015;205:848–52.
doi:10.2214/ajr.14.14266.
Giacomo GD,
Vita AD,
Costantini A,
Gasperis ND,
Scarso P.
Management of humeral head deficiencies and glenoid track.
Current Reviews in Musculoskeletal Medicine 2013;7:6–11.
doi:10.1007/s12178-013-9194-7.
Giacomo GD,
Itoi E,
Burkhart SS.
Evolving Concept of Bipolar Bone Loss and the Hill-Sachs Lesion: From “Engaging/Non-Engaging” Lesion to “On-Track/Off-Track” Lesion.
Arthroscopy: The Journal of Arthroscopic & Related Surgery 2014;30:90–8.
doi:10.1016/j.arthro.2013.10.004....
Personal Information
Dr.
Vivek Pai
Clinical Associate,
Department of Radiology,
SevenHills Hospital,
Mumbai,
India.
Email:
[email protected]
