44 y/o Martial arts enthusiast and MMA fighter. Injured in Jiu Jitsu 2 weeks ago. As an aside the guy was very nervous about the injection and as I walked into the room he said “Even though I am totally buff and am completely tatted’ I am deathly scared of needles.” I didn’t want to tell him that the most frightened people I see fit exactly into his demographic.
I’m showing the case because while the pre injection axial images show an anterior inferior labral injury and adjacent bone injury, it doesn’t look necessarily detached or at least not displaced. On the post injection axial it also looks a bit abnormal but not detached. ABER shows the tear with some displacement.
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2nd case is a 32 y/o F paramedic who has had a number of injuries over the years. She told me she was diagnosed with “instability” and “tendinitis”. The referring wrote biceps tendinopathy. The SLAP lesion is readily apparent (sorry about the arrows). The anterior inferior labral tear on the ABER was a surprise to me. I figure it is not seen on the axial sequences well because there has been some healing change which can result in resynovialization and block entrance of contrast into the defect until ABER stress is added.
We do ABER on every arthrogram. Acute injuries are excluded if the patient shows any apprehension at all. Some of my partners won’t do it at all if there has been a dislocation in the past.
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Phillip Tirman
