Glenohumeral instability refers to the humeral head not remaining properly aligned within the glenoid cavity. This condition can be categorized based on its underlying cause and the direction in which the instability occurs. When conducting imaging, it is important to consider the stabilizing components of the joint, including the glenoid labrum, glenohumeral ligaments, and bony anatomy. A key challenge in identifying labrum tears in MRI scans is distinguishing them from normal anatomical variants, as these can resemble pathological findings. To determine the presence of a Hill-Sachs lesion or off-track configuration, the size and position of the Hill-Sachs lesion must be correlated with glenoid rim defect. Not all labrum tears are related to previous dislocations; some occur independently. SLAP lesions, which are common, may resemble a superior sublabral recess, making diagnosis difficult. In overhead athletes, labrum injuries typically affect the posterosuperior quadrant, often in proximity to pathology of the posterior rotator cuff. Microinstability (functional instability, microtraumatic glenohumeral instability) is an acquired form of shoulder instability, which has been attributed to repetitive capsular microtrauma in chronic overuse without frank dislocation.

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Shoulder: Instability

  • Christian W. A. Pfirrmann,
  • Klaus Woertler

摘要

Glenohumeral instability refers to the humeral head not remaining properly aligned within the glenoid cavity. This condition can be categorized based on its underlying cause and the direction in which the instability occurs. When conducting imaging, it is important to consider the stabilizing components of the joint, including the glenoid labrum, glenohumeral ligaments, and bony anatomy. A key challenge in identifying labrum tears in MRI scans is distinguishing them from normal anatomical variants, as these can resemble pathological findings. To determine the presence of a Hill-Sachs lesion or off-track configuration, the size and position of the Hill-Sachs lesion must be correlated with glenoid rim defect. Not all labrum tears are related to previous dislocations; some occur independently. SLAP lesions, which are common, may resemble a superior sublabral recess, making diagnosis difficult. In overhead athletes, labrum injuries typically affect the posterosuperior quadrant, often in proximity to pathology of the posterior rotator cuff. Microinstability (functional instability, microtraumatic glenohumeral instability) is an acquired form of shoulder instability, which has been attributed to repetitive capsular microtrauma in chronic overuse without frank dislocation.