Humeral Avulsion of the Inferior Glenohumeral Ligament (HAGL) • Imaging Findings: • Large defect of the inferior glenohumeral ligament/joint capsule at the humeral attachment consistent with a capsule tear. • Intra-articular contrast is extravasating through the defect outside of the joint capsule. Case description: • Humeral Avulsion of the Glenohumeral Ligament (HAGL) can be a cause of anterior shoulder instability from the defective joint capsule. • Axillary pouch changes from a fluid-filled U-shaped structure to a "J-Shaped structure." • The IGHL sags inferiorly to form "J-shape." o Usually anterior shoulder dislocation WITHOUT Bankart lesion. Differential diagnosis: • Reverse HAGL (RHAGL) lesion: Posterior capsuloligamentous injury. • Bony Humeral Avulsion of the IGHL (BHAGL): Avulsion fracture at the inferior glenohumeral ligament/joint capsule attachment. • Glenoid Avulsion of the Glenohumeral Ligament (GAGL): "Reverse J sign." Avulsion of the joint capsule/IGHL from the inferior pole of the glenoid. No tear of the labrum. Dr. Donald von Borstel @DrvonBorstel #HAGL #Humeral #Avulsion #Glenohumeral #Ligament #shoulder #clinical #mri #clinical #Radiology #diagnosis #msk
