Case: 58yoF status post first time anterior dislocation reduced in the ER. It’s been known for a while that first time dislocators over the age of 40 tend to injure the rotator cuff with or without a labral tear. Younger patients, particularly teens, will have a bankart or bankart variation lesion in the great majority (as high as 95+%) of patients and a high level of recurrence. Cuff tears are rare.
This patient fits the mold and has a full thickness full width supraspinatus and infraspinatus tear as well as a capsular sprain and a mid ligament tear or partial tear (1st image mid axillary pouchIGHL). No labral detachment (no bankart).The anterior inferior labrum is abnormal but no fluid undermining it and no displacement and looks contiguous with the IGHL sprain. Tiny hill sachs. Interestingly she has a duplicated (accessory) biceps and the slip was partially torn as well as an overlying tear of the coracohumeral ligament (not shown).
Fellowship opportunities: This is a great fellowship headed up by Robert Lee and featuring John Crues (so world class faculty) and a huge variety of cases. I was John’s fellow back in 1991 and there is no better teacher. The fellowship is based in LA with one spot in my office in Agoura Hills, California in northern LA county on the Ventura county border.
RadNet Southern California MSK Fellowship, Los Angeles: 2 spots available for the 24-25 academic year.
The fellowship includes a high MSK MR/CT sports medicine volume, working closely with Kerlan-Jobe orthopedics as well as many other local and regional orthopedic groups.
We read for several professional, collegiate and Olympic teams with a wide range of pathology.
The fellowship includes training in joint injection/arthrography and a didactic lecture series.
No weekends or call and with moonlighting opportunities available.
If interested, visit the SSR site: https://skeletalrad.org/my-msk/fellowships/vacancies or feel free to send me an email!
