The history that was withheld was that of numerous prior anterior dislocations. About 95 % of all shoulder dislocations are anterior dislocations, as in this case. The Hill-Sachs lesions is an impaction fracture on the posterolateral margin of the humeral head. If this fracture is only minimally impacted, it may be visible as a small linear area of sclerosis. However, larger ones may show a large contour defect or notch, like the one seen in this case. This finding is present in 74 to 82 % of patients with an adequate radiographic exam.
Often, only the cartilaginous portion of the labrum is detached from the osseous portion of the glenoid, and is known as a Bankart lesion. These lesions can only be seen on arthrography or MR. In this patient, the osseous rim of the glenoid was also fractured.
The same findings shown on the AP radiograph also show up nicely on all of the CT slices. In addition to the Hill-Sachs and Bankart fractures, osteophytosis is also present, indicative of the development of secondary osteoarthritis.