Perthes’ Lesion
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Perthes’ Lesion. History of weightlifting and persistent shoulder pain. Anterior Ligamentous Periosteal Sleeve Avulsion (ALIPSA). Adhesive Capsulitis. Pectoralis Tendon Avulsion. 28M Posterior shoulder pain - No trauma. PDFS. Parsonage Turner. Superior surface tear Sag T2.

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Perthes’ Lesion

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Perthes’ Lesion

History of weightlifting and persistent shoulder pain


Anterior Ligamentous Periosteal Sleeve Avulsion (ALIPSA)


Adhesive Capsulitis


Pectoralis Tendon Avulsion


28MPosterior shoulder pain - No trauma

PDFS


Parsonage Turner


Superior surface tear Sag T2


Full Thickness Tear Cor T2


25M – Bench pressing

Axial T2 Shoulder


Pectoralis Major Rupture

  • Can be difficult to see

    • Especially chronically


25M - Pain

Cor T1 FS IAGd


Full Thickness Tear

  • Acute

    • Anterior edge of supraspinatus

  • Degenerative

    • Mid supraspiantus


56MPain on and off for years


Cor T1 FS IA Gd


Full Thickness Tear


67MRecent onset pain with abduction and internal rotation


Sag T2


High grade superior surface tearof supraspinatus


78FCannot comb her hair


Cor T2


Full Thickness Tear


35MWeightlifter


Axial T2 Shoulder


Pectoralis Major Rupture


24MPrevious shoulder dislocationwith spontaneous reduction


T1FS IAGd


T1FSIAGd


T2FS IAGd


Labral tear with paralabral cyst


53MPain and possible calcific tendinosis on X-ray


Ax T2FS


Sag PDFS


Cor T2FS

Cor T1


Calcific bursitis


Labral tear with intraosseous ganglion


Longitudinal biceps split


High grade undersurface and intra substance tear of SST


56MSwimming and body surfing in Hawaii 2 weeks ago; struck shoulder. Fracture/dislocation.Greater tuberosity fracture. R/o rotator cuff tear.


Findings

  • Fracture of posterolateral humeral head with avulsion of teres minor insertion

  • Joint effusion with large posterior collection

  • Extensive muscle edema and hemorrhage

  • Avulsion of infraspinatus tendon at insertion

  • Probable rupture of intraarticular biceps

  • Avulsion of posterior capsule

  • Supraspinatus tendinopathy


Ovesen J, Sojbjerg JO. Posterior shoulder dislocation.Acta Orthop Scand. 1986; 57: 535-536.

10 cadaver shoulders, provoked posterior subspinous gh joint dislocation

  • In 10/10: Teres minor rupture, posterior capsule rupture, and infraspinatus tear

  • In 8/10: Lower subscapularis tear

  • In 10/10: Intact supraspinatus and CH ligament


30M painful firm lump on arm


Ax T1FS

Ax T1

Ax T2

Ax T1FSGd

*

Possible angiolipoma


Angiolipoma

  • Rare, benign

  • Mature lipocytes with angiomatous prolif.

  • Young adults upper extremity

  • Firmer than lipoma

  • Noninfiltrating subQ, encapsulated

  • Infiltrating deep


T1FS IAGd


T1FSIAGd


T2FS IAGd


Labral tear with

paralabral cyst


53M

53M

Pain and possible biceps calcific tendonosis on X-ray


Ax T2FS


Sag PDFS


Cor T2FS

Cor T1

Calcific bursitis


60M

1Y shoulder pain and reduced ROM


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