), Pitfalls in Musculoskeletal Radiology. True cartilage defects of the humeral head are often located in the posterosuperior portion medial to the location of the bare area [3, 5, 6, 7]. The anterior band arises from the inferior glenoid rim at the two o’clock to four o’clock positions. Radiol Clin North Am. Indications for imaging of the shoulder have considerably increased in the last few years. (A) Axial PD-weighted and (B) Sagittal fat-suppressed T1-weighted MR arthrographic images show a cord-like middle glenohumeral ligament (white arrow) associated with an absent anterior superior labrum (black arrow) mimicking a labral tear with normal posterior labrum. An acromion with small slope angle has been described as ‘flat or downsloping acromion’ [5]. JBR-BTR. Buford complex. (B) Sagittal oblique PD-weighted MR arthrogram image shows the fasciculus obliquus (thick white arrows, B), the frenula capsulae (synovial bands) (thin white arrows, B) and the middle glenohumeral ligament (black arrows, B) can be identified on this sagittal section. 2017; 31–48: 296. Likewise, the superior capsule not only contains the superior glenohumeral ligament, the coracohumeral ligament, and the rotator cable but also the posterosuperior glenohumeral ligament as described by Pouliart et al., [14]. The patient is placed in supine position with the arm in mild external rotation. All lesions were observed as round or oval high-signal-intensity lesions on T2-weighted and fat-suppressed T1-weighted MR arthrography images. Os acromiale. Both instability and pseudarthrosis can increase after acromioplasty [4, 5, 7]. A posterosuperior glenohumeral ligament complements the superior glenohumeral ligament complex posteriorly. H… There are several bursae around the shoulder, the most important being the subacromial, subdeltoid, subscapular, and subcoracoid bursae (Figure 13, additional material). (a) Normal anatomy; (b) Sublabral recess (sublabral sulcus); (c) Sublabral foramen (sublabral hole); (d) Buford complex. Instead, they are typically pseudocysts that communicate with the joint space and represent a normal variant (Figure 3) [4, 6]. The supraspinatus muscle is best demonstrated on coronal oblique and axial sections as a thick, intermediate signal intensity structure tapering into a low signal intensity tendon that inserts into the superolateral aspect of the greater tuberosity. The rotator interval contains several important anatomical structures that contribute to the stability and normal function of the shoulder joint, including biceps tendon, coracohumeral ligament, superior glenohumeral ligament, rotator interval capsule, anterior fibers of the supraspinatus tendon, and superior fibers of the subscapularis tendon. Adjacent to the openings of pseudocysts, no degenerative changes such as thinning, cracking, or breakage in neighboring cartilage were observed. A follow-up MR study was ordered 1 month after the second treatment. Superior glenohumeral ligament. subchondral cyst humeral head. DOI: https://doi.org/10.1016/j.ejrad.2008.02.028, Cook, TS, Stein, JM, Simonson, S and Kim, W. Normal and variant anatomy of the shoulder on MRI. Normal anatomic structures that may mimic pathology. 2016; 36(7): 2084–2101. The cyst usually forms in the subchondral area of the joint which is just underneath the cartilage. Predilection sites: proximal humerus and femur. The superior glenohumeral ligament consists of two proximal attachments, one onto the anterosuperior aspect of the labrum conjoined with the biceps tendon (Figures 12 and 17), and the other onto the base of the coracoid process (Figure 18) [2]. Sublabral foramen is located between the one o’clock and three o’clock position and provides a communication between the glenohumeral joint and the subscapularis recess (white arrows). 2017. The subscapularis muscle arises from the subscapular fossa of the anterior face of the scapula and attaches to the lesser tuberosity. This ligament runs horizontally, almost parallel to the long head of the biceps tendon, straight in the direction of the coracoid process. However, ultrasonographic evaluation of the shoulder is limited to the long head of biceps tendon, the rotator cuff, the subacromial-subdeltoid bursa and the acromioclavicular joint. The os acromiale is an accessory bone due to nonunion of ossification center during development (Figure 9). The anterior capsular mechanism includes the anterior capsule, the glenohumeral ligaments, the synovial membrane and its recesses, the glenoid labrum, the subscapularis muscle and tendon, and the scapular periosteum. On sagittal CTA, the ligament appears as a T-shaped structure (thin white arrow, (B) Interposed between the long head of the biceps tendon posteriorly and the subscapularis tendon anteriorly. i have been in pain manegment four this shoulder is there anything else to do ? Variant appearances of the middle glenohumeral ligament include absence of the middle glenohumeral ligament, a conjoint origin with either the superior glenohumeral ligament or inferior glenohumeral ligament, and a cord-like thickening of the middle glenohumeral ligament in combination with an absent anterosuperior labrum (Buford complex) [7]. 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