X-ray shows anterior dislocation of the right shoulder. The | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

X-ray shows anterior dislocation of the right shoulder. The humeral head is displaced inferiorly and anteriorly in relation to the glenoid. The glenoid has caused an impaction injury of the posterolateral humeral head (Hill Sachs deformity). This image nicely shows the glenoid resting in the Hill sachs deformity. #MSKMonday

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AP (image 1) and axial (image 2) radiograph of the shoulder shows anteroinferior dislocation of the glenohumeral joint. Shoulder dislocations most commonly occur in the anterior direction. Radiologist should evaluate for associated injuries such as a Hill-Sachs deformity which is caused by impaction of the humeral head upon the glenoid.](https://app.figure1.com/case-detail/035f8165-fd62-404d-9900-5a55005055a3)


Sagittal T1-W MRI shows a Hill Sachs deformity of the humeral head. A Hill Sachs deformity is a compression fracture caused by anterior dislocation of the shoulder. The compression is caused by impaction with the inferior aspect of the glenoid. Patients with a Hill Sachs lesion are thought to be more likely to have recurrent dislocations.
#FridayQuizDay #Quiz #FridayQuiz](https://app.figure1.com/case-detail/0768cd84-4737-43ac-a989-3aaed63a7608)


🔥ANSWER: 🤕anterior shoulder dislocation with a Hill-Sachs lesion. The humeral head lies anterior, medial and inferior when compared to its usual location in the glenoid fossa. It lies directly below the coracoid process. The second image is a projection known as a modified Stripp axial view and it shows clearly that the humeral head and glenoid fossa are no longer in congruity (i.e. in joint). There is also a large dip in the contour of the posterolateral aspect of the humeral head, like a wedge. This is a compression fracture caused when this part of the humeral head is bashed against the anteroinferior aspect of the glenoid, usually when there have been recurrent dislocations and is known as a Hill-Sachs lesion. If there is associated injury of the glenoid itself, this is known as a Bankart lesion (not seen here).](https://app.figure1.com/case-detail/163b1f86-6879-4010-b591-fea0cc7e51b9)


AP (image 1) and scapular Y (image 2) images of the shoulder show an anterior shoulder dislocation with Hill-Sachs deformity (arrowhead on image 1 and arrow on image 2).](https://app.figure1.com/case-detail/2716a8d2-b772-48e8-848d-90492fe3db27)