MSK for Monday, April 7th, 2025

Contributed by Vanderbilt University Medical Center
Hamideh Ale Ali MD, and Jessica Leschied MD.

History

16-year-old male with right shoulder injury following MVC

Images (Click any image to enlarge)

Question

What is the injury and the name of the classic MRI sign depicted by the arrows?

Your answer

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Correct answer

HAGL or inferior glenohumeral ligament tear, and J sign

Discussion

The coronal STIR view and axial PD fat sat image through the proximal humerus shows avulsion injury of the inferior glenohumeral ligament off the humerus (sometimes referred to as HAGL lesion). The classic MRI finding is the “J sign”, referring to the J-shaped appearance of the torn inferior glenohumeral ligament.

References

Carlson C, MD, MS, The J sign, Radiology 2004 Sep 232:725–726 Bui-Mansfield LT, Banks KP, Taylor DC. Humeral Avulsion of the Glenohumeral Ligaments: The HAGL Lesion. The American Journal of Sports Medicine. 2007;35(11):1960-1966