Diagnosis of Hill-Sachs Lesion of the Shoulder

Abstract

Aim: The Hill-Sachs lesion is a compression fracture caused by impact on the trabeculae of the humeral head during anterior glenohumeral dislocation. The early and accurate identification of patients who risk recurrence of shoulder dislocation requires a suitable screening method. This should be characterized by high sensitivity and specificity, low cost, and repeatability.

Material and Methods: The results of ultrasound examination as a screening method were evaluated, the indicator being the identification of the Hill-Sachs lesion. Using ultrasonography and conventional radiological techniques, and double contrast CT (arthro-CT), we studied 60 patients with posttraumatic instability of the shoulder.

Results: Against arthro-CT as the true standard, ultrasonography showed a sensitivity of 95.6%, specificity of 92.8%, and diagnostic accuracy of 95%.

Conclusion: Ultrasonography is an acceptable screening examination for recurrent scapulohumeral dislocation and should be applied prior to other techniques of investigation such as arthro-CT or MR imaging.