Hill-Sachs lesion is seen in: March 2005, March 2013 (h)

Ans. D: Recurrent dislocation of shoulder A Hill-Sachs lesion usually results from recurrent anterior shoulder dislocation with resultant posterolateral humeral head compression fracture as the humeral head comes to rest against the anteroinferior pa of the glenoid. It is often associated with a Banka lesion of the glenoid (stripping of the glenoidal labrum along with the periosteum from the anterior surface of the glenoid and scapular neck). Plain film Best seen following re-location of the joint, and better appreciated on internal rotation views. It appears as a sclerotic veical line running from the top of the humeral head towards the shaft. If large then a wedge defect may be evident. CT and MRI Both MRI and CT are very sensitive to this lesion, which appears as a region of flattening or a wedge shaped defect (with bone marrow oedema on MRI acutely) seen involving the posterolateral humeral head above the level of the coracoid. This is usually seen in the most superior few slices, were the humeral head should be rounded. It is impoant to note that below the level of the coracoid the humeral head normally flattens out posterolaterally, and this should not be misinterpreted as a Hill-Sachs lesion