Hill-Sachs lesion: comparison of detection with MR imaging, radiography, and arthroscopy.

Abstract

Magnetic resonance (MR) imaging has proved to be a valuable method for documenting Hill-Sachs lesions. The authors retrospectively analyzed the diagnostic interpretations at plain film radiography, arthroscopy, and MR imaging in 76 patients. The analysis revealed that neither radiography nor arthroscopy displayed the lesion with sufficient accuracy to represent a true standard of reference for the evaluation of MR imaging in the diagnosis of the Hill-Sachs lesion. The data from the diagnostic interpretations were analyzed in three ways, each of which revealed that findings at MR imaging were more helpful than findings at radiography and/or arthroscopy in the diagnosis of the Hill-Sachs lesion. When the agreement of findings in two or three methods was used to assign a final diagnosis, MR imaging resulted in sensitivity of 97%, specificity of 91%, and accuracy of 94% in the detection of Hill-Sachs lesions.

Large Hill-Sachs Lesion: A Comparative Study of Patients Treated with Arthroscopic Bankart Repair with or without Remplissage

“…While they stated all Hill-Sachs were engaging, the size measurements were done on plain radiographs and by arthroscopy, which offers poor correlation and no quantification of the Hill-Sachs lesion's volume. Workman et al documented that plain radiographs and arthroscopy offer significantly worse detection and measurement outcomes compared to MRI with regard to humeral head defect measurements [17]. For the arthroscopic scoring, they reported 35 out of 50 patients (70%) had grade II or medium-size lesions; however, Burkhart et al suggests that the presence of engaging lesion is important but the large engaging Hill-Sachs lesions are the main cause of recurrence [3].…”

Accuracy of measurement of Hill-Sachs lesions with computed tomography

“…11,22 In addition, it is not only the size of the lesion that matters but also the amount of articular surface involvement and location of the defect relative to the glenoid track. 20,23 A large, deep defect that does not involve the articulating component of the humeral head may not be as significant as a smaller defect with a significant articular cartilage involvement.…”

Imaging of Shoulder Injuries in Sports Medicine: Current Protocols and Concepts

“…31,32 CT may show the bone component to better advantage, but MRI can reveal the presence of edema and confirm the more recent nature of the lesion (Fig. 21).…”