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GLAD/GARD Lesion
Michael J. Tuite, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Glenolabral articular disruption (GLAD)
              • Glenoid articular rim disruption (GARD) (or divot)
            • Synonyms

              • Bankart variation lesion
                • Bankart variants also include partial Bankart tear, Perthes lesion, ALPSA lesion
            • Definitions

              • GLAD lesion: Anteroinferior chondral lesion with superficial (small partial) tear of labrum and no instability on clinical exam
                • This is original definition; some now use GLAD for any labral tear with adjacent chondral lesion
              • GARD lesion: Chondral or osteochondral lesion adjacent to large instability-causing labral tear
                • Unstable on clinical exam

            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. Galano GJ et al: Articular shear of the anterior-inferior quadrant of the glenoid: a glenolabral articular disruption lesion variant. Am J Orthop (Belle Mead NJ). 42(1):41-3, 2013
                                      2. 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
                                      3. Waldt S et al: Anterior shoulder instability: accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries. Radiology. 237(2):578-83, 2005
                                      4. Amrami KK et al: Radiologic case study. Glenolabral articular disruption (GLAD) lesion. Orthopedics. 25(1):29, 95-6, 2002
                                      5. Sanders TG et al: Imaging techniques for the evaluation of glenohumeral instability. Am J Sports Med. 28(3):414-34, 2000
                                      6. Sanders TG et al: The glenolabral articular disruption lesion: MR arthrography with arthroscopic correlation. AJR Am J Roentgenol. 172(1):171-5, 1999
                                      7. Yu JS: The glenolabral articular disruption lesion: similarities to the glenoid osteochondral defect. AJR Am J Roentgenol. 173(3):850-1, 1999
                                      8. Neviaser TJ: The GLAD lesion: another cause of anterior shoulder pain. Arthroscopy. 9(1):22-3, 1993
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Glenolabral articular disruption (GLAD)
                                                  • Glenoid articular rim disruption (GARD) (or divot)
                                                • Synonyms

                                                  • Bankart variation lesion
                                                    • Bankart variants also include partial Bankart tear, Perthes lesion, ALPSA lesion
                                                • Definitions

                                                  • GLAD lesion: Anteroinferior chondral lesion with superficial (small partial) tear of labrum and no instability on clinical exam
                                                    • This is original definition; some now use GLAD for any labral tear with adjacent chondral lesion
                                                  • GARD lesion: Chondral or osteochondral lesion adjacent to large instability-causing labral tear
                                                    • Unstable on clinical exam

                                                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. Galano GJ et al: Articular shear of the anterior-inferior quadrant of the glenoid: a glenolabral articular disruption lesion variant. Am J Orthop (Belle Mead NJ). 42(1):41-3, 2013
                                                                          2. 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
                                                                          3. Waldt S et al: Anterior shoulder instability: accuracy of MR arthrography in the classification of anteroinferior labroligamentous injuries. Radiology. 237(2):578-83, 2005
                                                                          4. Amrami KK et al: Radiologic case study. Glenolabral articular disruption (GLAD) lesion. Orthopedics. 25(1):29, 95-6, 2002
                                                                          5. Sanders TG et al: Imaging techniques for the evaluation of glenohumeral instability. Am J Sports Med. 28(3):414-34, 2000
                                                                          6. Sanders TG et al: The glenolabral articular disruption lesion: MR arthrography with arthroscopic correlation. AJR Am J Roentgenol. 172(1):171-5, 1999
                                                                          7. Yu JS: The glenolabral articular disruption lesion: similarities to the glenoid osteochondral defect. AJR Am J Roentgenol. 173(3):850-1, 1999
                                                                          8. Neviaser TJ: The GLAD lesion: another cause of anterior shoulder pain. Arthroscopy. 9(1):22-3, 1993