Ultrasonography: A Highly Efficient Modality for Diagnosis of Hill-Sachs Lesions

Abstract

IntroductionHill-Sachs lesions are very common findings after anterior glenohumeral dislocation of the shoulder and especially after recurrent dislocations [2,4]. Although it is not a prognostic factor [6,7,11], except if the lesion is very big [1], it is still important for diagnosis and confirmation of anterior instability. Although in most cases simple radiograms are sufficient to make the diagnosis, there are cases which cannot be diagnosed by X-ray either because they are to small, or in the acute phase when an optimal X-ray can't be done [10]. Others diagnostic modalities, such as CT or MRI, are also very efficient and accurate for detection of HillSachs lesions [8,9]. These modalities have some disadvantages such as high cost, irradiation exposure, claustrophobia, and relative low availability compared to X-ray or ultrasonography. AbstractPurpose: To assess the usefulness of ultrasound in diagnosing Hill-Sachs lesions. Hill-Sachs lesions are very common findings after anterior gleno-humeral dislocation of the shoulder and especially after recurrent dislocations. The ultrasound examination offers many advantages including low cost, rapidity, repeatability, safety and no radiation exposure. It is an accurate method for diagnosis of Hill-Sachs lesions. We present here our experience with ultrasound usage in the diagnosis of Hill-Sachs lesions. Material and Methods: 160 shoulders of 80 consecutive patients (58 males, 22 females) had ultra-sonograms during two years due to diagnosis of anterior gleno-humeral dislocation of the shoulder. Results: Hill-Sachs lesions were found in 73 (91 %) of the 80 suspicious shoulders that were examined. The average depth of the lesions was 3.08 ± 1.1 mm, range between 2 to 5.2 mm. The average area of the lesions was 25.21 ± 20.66 mm 2 , range between 9 to 110 mm 2 . Conclusions: Sonography is a useful and effective tool in the evaluation and diagnosis of Hill-Sachs lesions. Zusammenfassung160 Schultergelenke von 80 konsekutiven Patienten (58 Männer, 22 Frauen) wurden innerhalb von 2 Jahren nach Diagnose einer anterioren Schulterluxation sonographisch untersucht. Eine Hill-Sachs-Läsion fand sich in 73 (91 %) der 80 verletzten Schultergelenke. Die durchschnittliche Tiefe der Läsionen betrug 25,21 mm 2 (9 bis 110 mm 2 ). Die Sonographie hat sich als effiziente Methode zur Diagnostik von Hill-Sachs-Läsionen erwiesen. Varia 29Institutsangaben