Latest Research: How to treat off-track Hills- Sachs shoulder lesions

RadSource MRI Web Clinic — March 2021

by: Dr. Mark H. Awh, M.D.

Anterior shoulder instability is a commonly encountered clinical entity, and MRI has long proven valuable in its evaluation. Glenoid bone loss and large Hill-Sachs lesions are known to be associated with a greater risk of recurrent dislocation, but we now recognize that it is the relationship between these bipolar sites of bone loss that is critical in estimating the risk. By determining whether a Hill-Sachs lesion is on-track or off-track, one can predict the likelihood that the lesion will engage in abduction, a status known to be highly correlated to recurrent instability. The astute interpreter of MRI should determine whether a Hill-Sachs lesion is on- or off-track in all cases of anterior shoulder instability. Careful evaluation of this status as well as the extent of glenoid bone loss provides valuable guidance towards the operative approach.

You may read the web clinic here: Off-track Shoulder Lesions