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ALPSA Lesion
Michael J. Tuite, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Anterior labrum periosteal sleeve avulsion (ALPSA)
          • Synonyms

            • Bankart variation lesion
              • Also includes Perthes lesion, partial Bankart tear, glenolabral articular disruption (GLAD) lesion
          • Definitions

            • Torn anteroinferior labrum medially displaced and attached to scapula only by periosteum

          IMAGING

          • General Features

            • Radiographic Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    Selected References

                                    1. Bernhardson AS et al: Glenoid bone loss in the setting of an anterior labroligamentous periosteal sleeve avulsion tear. Am J Sports Med. 42(9):2136-40, 2014
                                    2. Mutlu S et al: Anterior glenohumeral instability: classification of pathologies of anteroinferior labroligamentous structures using MR arthrography. Adv Orthop. 2013:473194, 2013
                                    3. Lee BG et al: Anterior labroligamentous periosteal sleeve avulsion lesion in arthroscopic capsulolabral repair for anterior shoulder instability. Knee Surg Sports Traumatol Arthrosc. 19(9):1563-9, 2011
                                    4. Schreinemachers SA et al: Is a single direct MR arthrography series in ABER position as accurate in detecting anteroinferior labroligamentous lesions as conventional MR arthography? Skeletal Radiol. 38(7):675-83, 2009
                                    5. Ozbaydar M et al: Results of arthroscopic capsulolabral repair: Bankart lesion versus anterior labroligamentous periosteal sleeve avulsion lesion. Arthroscopy. 24(11):1277-83, 2008
                                    6. Antonio GE et al: First-time shoulder dislocation: High prevalence of labral injury and age-related differences revealed by MR arthrography. J Magn Reson Imaging. 26(4):983-91, 2007
                                    7. Yiannakopoulos CK et al: A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy. 23(9):985-90, 2007
                                    8. Song HT et al: Anterior-inferior labral lesions of recurrent shoulder dislocation evaluated by MR arthrography in an adduction internal rotation (ADIR) position. J Magn Reson Imaging. 23(1):29-35, 2006
                                    9. Waldt S et al: Anterior shoulder instability: accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries. Radiology. 237(2):578-83, 2005
                                    10. Neviaser TJ: The anterior labroligamentous periosteal sleeve avulsion lesion: a cause of anterior instability of the shoulder. Arthroscopy. 9(1):17-21, 1993
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Anterior labrum periosteal sleeve avulsion (ALPSA)
                                            • Synonyms

                                              • Bankart variation lesion
                                                • Also includes Perthes lesion, partial Bankart tear, glenolabral articular disruption (GLAD) lesion
                                            • Definitions

                                              • Torn anteroinferior labrum medially displaced and attached to scapula only by periosteum

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • MR Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Staging, Grading, & Classification

                                                          • Gross Pathologic & Surgical Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      Selected References

                                                                      1. Bernhardson AS et al: Glenoid bone loss in the setting of an anterior labroligamentous periosteal sleeve avulsion tear. Am J Sports Med. 42(9):2136-40, 2014
                                                                      2. Mutlu S et al: Anterior glenohumeral instability: classification of pathologies of anteroinferior labroligamentous structures using MR arthrography. Adv Orthop. 2013:473194, 2013
                                                                      3. Lee BG et al: Anterior labroligamentous periosteal sleeve avulsion lesion in arthroscopic capsulolabral repair for anterior shoulder instability. Knee Surg Sports Traumatol Arthrosc. 19(9):1563-9, 2011
                                                                      4. Schreinemachers SA et al: Is a single direct MR arthrography series in ABER position as accurate in detecting anteroinferior labroligamentous lesions as conventional MR arthography? Skeletal Radiol. 38(7):675-83, 2009
                                                                      5. Ozbaydar M et al: Results of arthroscopic capsulolabral repair: Bankart lesion versus anterior labroligamentous periosteal sleeve avulsion lesion. Arthroscopy. 24(11):1277-83, 2008
                                                                      6. Antonio GE et al: First-time shoulder dislocation: High prevalence of labral injury and age-related differences revealed by MR arthrography. J Magn Reson Imaging. 26(4):983-91, 2007
                                                                      7. Yiannakopoulos CK et al: A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy. 23(9):985-90, 2007
                                                                      8. Song HT et al: Anterior-inferior labral lesions of recurrent shoulder dislocation evaluated by MR arthrography in an adduction internal rotation (ADIR) position. J Magn Reson Imaging. 23(1):29-35, 2006
                                                                      9. Waldt S et al: Anterior shoulder instability: accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries. Radiology. 237(2):578-83, 2005
                                                                      10. Neviaser TJ: The anterior labroligamentous periosteal sleeve avulsion lesion: a cause of anterior instability of the shoulder. Arthroscopy. 9(1):17-21, 1993