NSI, 255 North Sykes Creek Parkway, Merritt Island, FL, 33573, USA,
Skeletal Radiol. 2014 Mar;43(3):307-13. doi: 10.1007/s00256-013-1778-1. Epub 2013 Dec 15.
Humeral avulsion of the glenohumeral ligament (HAGL) is an uncommon shoulder injury. We report the prevalence of HAGL lesions and other associated shoulder injuries in a large series of shoulder MR examinations. All results were correlated with surgery.
MR reports of 1,000 consecutive conventional shoulder MR exams performed on patients with shoulder pain were reviewed in our information system for the word HAGL. A total of 743 patients went on to surgery. There were 23 HAGL lesions reported at surgery. Those 23 examinations were reviewed retrospectively in consensus by two musculoskeletal radiologists. Scans were assessed for HAGL lesions, full or partial thickness supraspinatus, infraspinatus or subscapularis tendon tears, superior labral anterior posterior (SLAP) tears, anterior or posterior labral tears, and Hill-Sachs lesions.
All 23 patients had HAGL lesions at surgery. Sixteen HAGL lesions were seen on prospective MR reading and 17 HAGL lesions were seen on retrospective MR consensus reading. Six HAGL lesions were not seen on retrospective consensus reading. Sixteen patients had Hill-Sachs deformities, ten had subscapularis tendon tears, five had supraspinatus tendon tears, six had superior labral tearing, and six had anterior labral tears. The above findings were confirmed on arthroscopy.
In this series, there was a 1.6 % prevalence on all MR examinations, and prevalence of 2.1 % seen on MR examination for those who went to surgery. Common injuries associated with HAGL lesions are Hill-Sachs deformities and subscapularis tendon tears. Anterior labral tears were seen in only six cases despite Hill-Sachs deformities in 16 patients. In patients with Hill-Sachs deformities without anterior labral tears, one must carefully assess for the presence of a HAGL lesion.
肩盂唇肱骨止点撕脱（HAGL）损伤是一种不常见的肩关节损伤。我们报告了在大量肩关节磁共振检查中 HAGL 病变及其他相关肩关节损伤的发生率，并将所有结果与手术进行了相关性分析。
在我们的信息系统中，对因肩关节疼痛而行常规肩关节磁共振检查的 1000 例连续患者的磁共振报告进行了 HAGL 词检索。共有 743 例患者接受了手术治疗。手术中共报告 23 例 HAGL 病变。这 23 例检查由两位肌肉骨骼放射科医生进行了回顾性共识复查。对 HAGL 病变、肩袖完全或部分厚度的冈上肌、冈下肌或肩胛下肌肌腱撕裂、上盂唇前后（SLAP）撕裂、前或后盂唇撕裂以及 Hill-Sachs 病变进行了扫描评估。
所有 23 例患者在手术中均存在 HAGL 病变。前瞻性磁共振阅读发现 16 例 HAGL 病变，回顾性磁共振共识阅读发现 17 例 HAGL 病变，而 6 例 HAGL 病变未在回顾性共识阅读中发现。16 例患者存在 Hill-Sachs 畸形，10 例存在肩胛下肌肌腱撕裂，5 例存在冈上肌肌腱撕裂，6 例存在上盂唇撕裂，6 例存在前盂唇撕裂。这些发现均经关节镜检查证实。
在本系列中，所有磁共振检查的发生率为 1.6%，而接受手术治疗的患者中，磁共振检查的发生率为 2.1%。与 HAGL 病变相关的常见损伤是 Hill-Sachs 畸形和肩胛下肌肌腱撕裂。尽管 16 例患者存在 Hill-Sachs 畸形，但仅发现 6 例存在前盂唇撕裂。对于存在 Hill-Sachs 畸形而无前盂唇撕裂的患者，必须仔细评估是否存在 HAGL 病变。
