肩関節前方不安定症における HAGL 病変と関節包断裂の超音波診断

概要

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Background: Capsular tear and the HAGL lesion are the important pathologies of the shoulder instability like Bankart lesion. The purpose of this study was to clarify the efficacy of the US in detecting capsular tear and HAGL lesion. Methods: Subjects comprised 98 patients (mean age, 20.6 years, 78 men, 20 women) who underwent surgery for treatment of traumatic anterior shoulder instability. All shoulder joints were checked preoperatively by the US. The criteria of the capsular tear was the discontinuity or absence of the high echo line at the humeral head. The criteria of the HAGL lesion was the discontinuity or absence of the capsule at the humeral neck. Intraoperatively, we checked the anterior capsule and the attachment of the capsule at the humeral neck and made sure of the existence of capsular tear and HAGL lesion for all cases. Results: Capsular tear was present in 30 cases and the HAGL lesion was present in 4 cases of 98 shoulder joints. Two cases where the size of HAGL lesion were 1 × 1cm were not able to be detected by US. In some cases that had a big capsular tear, we diagnosed them as HAGL lesion. The US had an accuracy of 89.7 % in the detection of a HAGL lesion and an accuracy of 85.6 % in the detection of a capsular tear. Conclusion: We considered that the US is useful technique in detecting the capsular tear and the HAGL lesion.
日本肩関節学会の論文