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Click 69 year old male with traumatic anterior glenohumeral dislocation with failed reduction after multiple attempts, complete rotator cuff tear, posterior dislocation long head of biceps tendon and haemarthrosis. Unenhanced MDCT, 125 mAs, 120kV, slice thickness 1mm, increment 0.5 mm (Brilliance CT 64-channel, Philips, Surrey, UK).
The humeral head remains subluxed anteriorly with respect to the glenoid. A soft tissue “mass” is seen posterior to the joint which is a large haemarthrosis likely secondary to warfarin therapy. This disrupts the course of infraspinatus and teres minor tendons. The subscapularis also has an abnormal course and appears to fold into the anterior joint space. A tiny flake of bone is seen at the edge of the haemarthrosis presumably from the greater tuberosity.


Click 69 year old male with traumatic anterior glenohumeral dislocation with failed reduction after multiple attempts, complete rotator cuff tear, posterior dislocation long head of biceps tendon and haemarthrosis. Axial gradient echo MRI
1.5T; TR/TE/Flip angle: 1300ms/27ms/30 degrees; FOV 200; matrix 410 x 512; slice thickness 4 mm.
There is anterior subluxation of the humerus. There is an abnormal course of subscapularis with the disrupted tendon insertion folded into the anterior joint space. The multiloculated haemarthrosis with fluid-fluid levels is seen posterior to the joint. The tiny avulsion fracture, seen as a small hypointense focus lies laterally. Disrupted infraspinatus and teres minor insertions are seen.
The long head of biceps tendon has slipped over the greater tuberosity. On the more cranial slices it lies posterior to the humeral head deep to the haemarthrosis and as we move caudally it comes lateral to the humerus.


Click 69 year old male with traumatic anterior glenohumeral dislocation with failed reduction after multiple attempts, complete rotator cuff tear, posterior dislocation long head of biceps tendon and haemarthrosis. Coronal oblique STIR; 1.5T; TR/TE/time to inversion: 4290ms/29ms/130ms; FOV 160; matrix 394 x 512; slice thickness 4 mm
The long head of biceps tendon can be seen at its origin on the superior glenoid and the intra-articular portion is seen more posteriorly. Moving posteriorly in the stack it is then seen to lie posteriorly with respect to the bicipital groove and can be seen dislocated posterior to the humerus. There is a full-thickness tear of supraspinatus with retraction and the abnormal course of subscapularis is seen.


Click 69 year old male with traumatic anterior glenohumeral dislocation with failed reduction after multiple attempts, complete rotator cuff tear, posterior dislocation long head of biceps tendon and haemarthrosis. Sagittal oblique proton-density ; 1.5T; TR/TE: 3570ms/15ms; FOV 160; matrix 512 x 512; slice thickness 4 mm
The long head of biceps tendon is most easily followed on this sequence. On the more medial slices it is seen just lateral to its origin. Moving laterally the posteriorly dislocated long head of biceps tendon can be seen. Moving further laterally it wraps around the humeral shaft to come to lie anteriorly. The musculotendinous portions of the rotator cuff: supraspinatus, infraspinatus and teres minor are seen in a clockwise direction on the more medial images. Moving laterally the torn, retracted supraspinatus, infraspinatus and teres minor are demonstrated with no rotator cuff tendons seen on the more lateral images.