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

Perthes’ Lesion

History of weightlifting and persistent shoulder pain


Perthes lesion

Anterior Ligamentous Periosteal Sleeve Avulsion (ALIPSA)


Perthes lesion

Adhesive Capsulitis


Perthes lesion

Pectoralis Tendon Avulsion


28m posterior shoulder pain no trauma

28MPosterior shoulder pain - No trauma

PDFS


Parsonage turner

Parsonage Turner


Superior surface tear sag t2

Superior surface tear Sag T2


Full thickness tear cor t2

Full Thickness Tear Cor T2


25m bench pressing

25M – Bench pressing

Axial T2 Shoulder


Pectoralis major rupture

Pectoralis Major Rupture

  • Can be difficult to see

    • Especially chronically


25m pain

25M - Pain

Cor T1 FS IAGd


Full thickness tear

Full Thickness Tear

  • Acute

    • Anterior edge of supraspinatus

  • Degenerative

    • Mid supraspiantus


56m pain on and off for years

56MPain on and off for years


Cor t1 fs ia gd

Cor T1 FS IA Gd


Full thickness tear1

Full Thickness Tear


67m recent onset pain with abduction and internal rotation

67MRecent onset pain with abduction and internal rotation


Sag t2

Sag T2


High grade superior surface tear of supraspinatus

High grade superior surface tearof supraspinatus


78f cannot comb her hair

78FCannot comb her hair


Cor t2

Cor T2


Full thickness tear2

Full Thickness Tear


35m weightlifter

35MWeightlifter


Perthes lesion

Axial T2 Shoulder


Pectoralis major rupture1

Pectoralis Major Rupture


24m previous shoulder dislocation with spontaneous reduction

24MPrevious shoulder dislocationwith spontaneous reduction


Perthes lesion

T1FS IAGd


Perthes lesion

T1FSIAGd


Perthes lesion

T2FS IAGd


Labral tear with paralabral cyst

Labral tear with paralabral cyst


53m pain and possible calcific tendinosis on x ray

53MPain and possible calcific tendinosis on X-ray


Perthes lesion

Ax T2FS


Perthes lesion

Sag PDFS


Perthes lesion

Cor T2FS

Cor T1


Calcific bursitis

Calcific bursitis


Labral tear with intraosseous ganglion

Labral tear with intraosseous ganglion


Longitudinal biceps split

Longitudinal biceps split


High grade undersurface and intra substance tear of sst

High grade undersurface and intra substance tear of SST


Perthes lesion

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


Perthes lesion

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

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

30M painful firm lump on arm


Perthes lesion

Ax T1FS

Ax T1

Ax T2

Ax T1FSGd

*

Possible angiolipoma


Angiolipoma

Angiolipoma

  • Rare, benign

  • Mature lipocytes with angiomatous prolif.

  • Young adults upper extremity

  • Firmer than lipoma

  • Noninfiltrating subQ, encapsulated

  • Infiltrating deep


Perthes lesion

T1FS IAGd


Perthes lesion

T1FSIAGd


Perthes lesion

T2FS IAGd


Perthes lesion

Labral tear with

paralabral cyst


Perthes lesion

53M

53M

Pain and possible biceps calcific tendonosis on X-ray


Perthes lesion

Ax T2FS


Perthes lesion

Sag PDFS


Perthes lesion

Cor T2FS

Cor T1

Calcific bursitis


Perthes lesion

60M

1Y shoulder pain and reduced ROM


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