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ALPSA (anterior labroligamentous periosteal sleeve avulsion) lesion

Ly JL - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Wilford Hall USAF Medical Center

ABSTRACT

Diagnosis: ALPSA (anterior labroligamentous periosteal sleeve avulsion) lesion

History: An 18-year-old football player presents with a chief complaint of chronic left shoulder pain and decreased range of motion. The patient reported a history of a traumatic dislocation two years ago for which the patient received no follow up treatment. The patient claims his shoulder has "fallen out of its socket" several times in the last six months.

Findings: Radiography was unremarkable, showing no evidence of prior traumatic osseous injury. MR Arthrography revealed avulsion and displacement of the anteroinferior labrum medially from its site of attachment at the glenoid rim. There remains an intact sleeve of periosteum attaching the labrum to the medial scapula (Fig. 1).

Ddx: Bankart, fibrous vs osseous Perthes lesion GLAD lesion

Exam: Physical exam revealed an unstable humeral head in the glenoid labrum with passive range of motion. Moreover, a popping sensation was appreciated by the examiner.

No MeSH data available.


ALSPA lesion.  The anteroinferior labrum is torn and slighlty lifted off the glenoid rim, with stripping of the anterior scapular periosteum.  Note though that although the periosteum is stripped, it is not comletely torn, preventing the ALPSA lesion from migrating further away from its current position.  This latter finding differentiates the ALPSA from the Bankart lesion.
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MPX1546_synpic15698: ALSPA lesion. The anteroinferior labrum is torn and slighlty lifted off the glenoid rim, with stripping of the anterior scapular periosteum. Note though that although the periosteum is stripped, it is not comletely torn, preventing the ALPSA lesion from migrating further away from its current position. This latter finding differentiates the ALPSA from the Bankart lesion.


ALPSA (anterior labroligamentous periosteal sleeve avulsion) lesion

Ly JL - MedPix

ALSPA lesion.  The anteroinferior labrum is torn and slighlty lifted off the glenoid rim, with stripping of the anterior scapular periosteum.  Note though that although the periosteum is stripped, it is not comletely torn, preventing the ALPSA lesion from migrating further away from its current position.  This latter finding differentiates the ALPSA from the Bankart lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1546&req=5

MPX1546_synpic15698: ALSPA lesion. The anteroinferior labrum is torn and slighlty lifted off the glenoid rim, with stripping of the anterior scapular periosteum. Note though that although the periosteum is stripped, it is not comletely torn, preventing the ALPSA lesion from migrating further away from its current position. This latter finding differentiates the ALPSA from the Bankart lesion.

View Article: MedPix Image - MedPix Case

Affiliation: Wilford Hall USAF Medical Center

ABSTRACT

Diagnosis: ALPSA (anterior labroligamentous periosteal sleeve avulsion) lesion

History: An 18-year-old football player presents with a chief complaint of chronic left shoulder pain and decreased range of motion. The patient reported a history of a traumatic dislocation two years ago for which the patient received no follow up treatment. The patient claims his shoulder has "fallen out of its socket" several times in the last six months.

Findings: Radiography was unremarkable, showing no evidence of prior traumatic osseous injury. MR Arthrography revealed avulsion and displacement of the anteroinferior labrum medially from its site of attachment at the glenoid rim. There remains an intact sleeve of periosteum attaching the labrum to the medial scapula (Fig. 1).

Ddx: Bankart, fibrous vs osseous Perthes lesion GLAD lesion

Exam: Physical exam revealed an unstable humeral head in the glenoid labrum with passive range of motion. Moreover, a popping sensation was appreciated by the examiner.

No MeSH data available.