Hill-Sachs lesion: sonographic detection

Farin, P.; Kaukanen, Erkki; Jaroma, H; Harju, A.; Väätäinen, Urho

doi:10.1007/s002560050135

Cited by 25 publications

(29 citation statements)

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“…Identification of large Hill-Sachs lesions is important because it may indicate a predisposition for recurrent luxation. Our results, 91 % (71 out of 80 shoulders), are similar to other previous reports, such as 88 % (54 out of 61 shoulders) [3] and 94 % (81 out of 86 shoulders) [5]. The average lesion size, such as depth of 3.08 ± 1.1 mm, range between 2 to 5.2 mm and area of 25.21 ± 20.66 mm 2 , range between 9 to 110 mm 2 , was close to other reports [3].…”

Section: Discussionsupporting

confidence: 95%

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Ultrasonography: A Highly Efficient Modality for Diagnosis of Hill-Sachs Lesions

Dudkiewicz¹,

Blankstein²

2006

Akt Traumatol

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IntroductionHill-Sachs lesions are very common findings after anterior glenohumeral dislocation of the shoulder and especially after recurrent dislocations [2,4]. Although it is not a prognostic factor [6,7,11], except if the lesion is very big [1], it is still important for diagnosis and confirmation of anterior instability. Although in most cases simple radiograms are sufficient to make the diagnosis, there are cases which cannot be diagnosed by X-ray either because they are to small, or in the acute phase when an optimal X-ray can't be done [10]. Others diagnostic modalities, such as CT or MRI, are also very efficient and accurate for detection of HillSachs lesions [8,9]. These modalities have some disadvantages such as high cost, irradiation exposure, claustrophobia, and relative low availability compared to X-ray or ultrasonography. AbstractPurpose: To assess the usefulness of ultrasound in diagnosing Hill-Sachs lesions. Hill-Sachs lesions are very common findings after anterior gleno-humeral dislocation of the shoulder and especially after recurrent dislocations. The ultrasound examination offers many advantages including low cost, rapidity, repeatability, safety and no radiation exposure. It is an accurate method for diagnosis of Hill-Sachs lesions. We present here our experience with ultrasound usage in the diagnosis of Hill-Sachs lesions. Material and Methods: 160 shoulders of 80 consecutive patients (58 males, 22 females) had ultra-sonograms during two years due to diagnosis of anterior gleno-humeral dislocation of the shoulder. Results: Hill-Sachs lesions were found in 73 (91 %) of the 80 suspicious shoulders that were examined. The average depth of the lesions was 3.08 ± 1.1 mm, range between 2 to 5.2 mm. The average area of the lesions was 25.21 ± 20.66 mm 2 , range between 9 to 110 mm 2 . Conclusions: Sonography is a useful and effective tool in the evaluation and diagnosis of Hill-Sachs lesions. Zusammenfassung160 Schultergelenke von 80 konsekutiven Patienten (58 Männer, 22 Frauen) wurden innerhalb von 2 Jahren nach Diagnose einer anterioren Schulterluxation sonographisch untersucht. Eine Hill-Sachs-Läsion fand sich in 73 (91 %) der 80 verletzten Schultergelenke. Die durchschnittliche Tiefe der Läsionen betrug 25,21 mm 2 (9 bis 110 mm 2 ). Die Sonographie hat sich als effiziente Methode zur Diagnostik von Hill-Sachs-Läsionen erwiesen. Varia 29Institutsangaben

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Section: Discussionsupporting

confidence: 95%

“…Ultrasonography is a safe, cheap, available, comfortable and accurate method for diagnosis of Hill-Sachs lesions [3,5,9]. We present here our experience with ultrasound usage in the diagnosis of Hill-Sachs lesions.…”

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confidence: 97%

Ultrasonography: A Highly Efficient Modality for Diagnosis of Hill-Sachs Lesions

Dudkiewicz¹,

Blankstein²

2006

Akt Traumatol

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“…It's advantageous as it is readily available, avoids radiation, and allows one to obtain dynamic multi-planar images [38] . Ultrasound scanning has also been shown to have a sensitivity and specificity comparable with CT arthrograms in identifying Hill-Sachs lesions [39] . However, its limitations include operator dependence and it cannot be used to quantify the size of the humeral head defect, and thus has a limited role in pre-operative planning.…”

Section: Ultrasonography and Humeral Bone Lossmentioning

confidence: 99%

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Ramhamadany

Modi

2016

WJO

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The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures.

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“…In concordance with fractures of the tuberosity complex of the humerus, it is reported that Hill-Sachs lesions are frequently missed with plain radiography [21], whereas sonographically Hill-Sachs lesions can be detected reliably (sensitivity: 91-96%, specificity: 95-100%, accuracy: 94-97%) [9,22]. Bodner et al [7] showed that common injuries like stress fractures, which are frequently overlooked on first radiographs, can be detected with US.…”

Section: Diagnostic Work-upmentioning

confidence: 92%

“…A limited number of articles has been published about the reliability and value of ultrasound (US) in the detection of fractures in general [2][3][4][5][6][7] and the proximal humerus [8][9][10][11][12] in particular.…”

Section: Introductionmentioning

confidence: 99%

Double line sign: a helpful sonographic sign to detect occult fractures of the proximal humerus

Rutten

Jager

Malefijt³

et al. 2006

Eur Radiol

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The aim of this study was to describe a new sonographic sign of bone fracture and to determine if it can be helpful in decreasing the number of missed fractures of the proximal humerus. Ultrasound (US) of the shoulder was performed in 57 consecutive patients with shoulder pain and/or disability following trauma. All cases were prospectively reviewed for the presence of a humeral fracture. Sonographic signs of fractures, with special emphasis on what was termed the 'double line sign' (DLS), were assessed. Plain radiography was considered the standard of reference and in equivocal cases magnetic resonance imaging (MRI). Twenty-eight patients had a tuberosity complex fracture, which were all detected at US examination. Sonographic features of a fracture were periosteal elevation, corticol bone discontinuity, step-off deformity or a combination of these findings. This study showed that in 26 (93%) patients an additional sonographic feature, a DLS, could be demonstrated. The DLS is a helpful and probably reliable sonographic sign to indicate a humeral fracture. High-spatial-resolution US substantially increases the detection of fractures of the proximal humerus and should be considered as an alternative diagnostic tool prior to computed tomography (CT), MRI and arthroscopy in patients with persisting shoulder pain and/or disability following trauma.

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Hill-Sachs lesion: sonographic detection

Cited by 25 publications

References 0 publications

Ultrasonography: A Highly Efficient Modality for Diagnosis of Hill-Sachs Lesions

Ultrasonography: A Highly Efficient Modality for Diagnosis of Hill-Sachs Lesions

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Double line sign: a helpful sonographic sign to detect occult fractures of the proximal humerus

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