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HAGL Lesion
Michael J. Tuite, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Humeral avulsion of glenohumeral ligament (HAGL)
              • Synonyms

                • Lateral inferior glenohumeral ligament (IGHL) tear
                • If avulsion fracture: Bony humeral avulsion of glenohumeral ligament (BHAGL)
              • Definitions

                • Avulsion of IGHL from humeral insertion

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT 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. Magee T: Prevalence of HAGL lesions and associated abnormalities on shoulder MR examination. Skeletal Radiol. 43(3):307-13, 2014
                                          2. Maldjian C et al: Evaluation of contrast extravasation as a diagnostic criterion in the evaluation of arthroscopically proven HAGL/pHAGL lesions. Radiol Res Pract. 2014:283575, 2014
                                          3. Park KJ et al: A large humeral avulsion of the glenohumeral ligaments decreases stability that can be restored with repair. Clin Orthop Relat Res. 472(8):2372-9, 2014
                                          4. George MS et al: Humeral avulsion of glenohumeral ligaments. J Am Acad Orthop Surg. 19(3):127-33, 2011
                                          5. Taljanovic MS et al: Humeral avulsion of the inferior glenohumeral ligament in college female volleyball players caused by repetitive microtrauma. Am J Sports Med. 39(5):1067-76, 2011
                                          6. Murphy DT et al: Humeral avulsion of the glenohumeral ligament. AJR Am J Roentgenol. 193(1):W74-5; author reply W76, 2009
                                          7. Melvin JS et al: MRI of HAGL lesions: four arthroscopically confirmed cases of false-positive diagnosis. AJR Am J Roentgenol. 191(3):730-4, 2008
                                          8. Bui-Mansfield LT et al: Humeral avulsion of the glenohumeral ligaments: the HAGL lesion. Am J Sports Med. 35(11):1960-6, 2007
                                          9. Rhee YG et al: Anterior shoulder instability with humeral avulsion of the glenohumeral ligament lesion. J Shoulder Elbow Surg. 16(2):188-92, 2007
                                          10. 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
                                          11. Pouliart N et al: Simulated humeral avulsion of the glenohumeral ligaments: a new instability model. J Shoulder Elbow Surg. 15(6):728-35, 2006
                                          12. Arciero RA et al: Mini-open repair technique of HAGL (humeral avulsion of the glenohumeral ligament) lesion. Arthroscopy. 21(9):1152, 2005
                                          13. Spang JT et al: The HAGL lesion: an arthroscopic technique for repair of humeral avulsion of the glenohumeral ligaments. Arthroscopy. 21(4):498-502, 2005
                                          14. Chhabra A et al: Arthroscopic repair of a posterior humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion. Arthroscopy. 20 Suppl 2:73-6, 2004
                                          15. Richards DP et al: Arthroscopic humeral avulsion of the glenohumeral ligaments (HAGL) repair. Arthroscopy. 20 Suppl 2:134-41, 2004
                                          16. Bui-Mansfield LT et al: Humeral avulsions of the glenohumeral ligament: imaging features and a review of the literature. AJR Am J Roentgenol. 179(3):649-55, 2002
                                          17. Coates MH et al: Humeral avulsion of the anterior band of the inferior glenohumeral ligament with associated subscapularis bony avulsion in skeletally immature patients. Skeletal Radiol. 30(12):661-6, 2001
                                          18. Bokor DJ et al: Anterior instability of the glenohumeral joint with humeral avulsion of the glenohumeral ligament. A review of 41 cases. J Bone Joint Surg Br. 81(1):93-6, 1999
                                          19. Wolf EM et al: Humeral avulsion of glenohumeral ligaments as a cause of anterior shoulder instability. Arthroscopy. 11(5):600-7, 1995
                                          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

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Humeral avulsion of glenohumeral ligament (HAGL)
                                                      • Synonyms

                                                        • Lateral inferior glenohumeral ligament (IGHL) tear
                                                        • If avulsion fracture: Bony humeral avulsion of glenohumeral ligament (BHAGL)
                                                      • Definitions

                                                        • Avulsion of IGHL from humeral insertion

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT 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. Magee T: Prevalence of HAGL lesions and associated abnormalities on shoulder MR examination. Skeletal Radiol. 43(3):307-13, 2014
                                                                                  2. Maldjian C et al: Evaluation of contrast extravasation as a diagnostic criterion in the evaluation of arthroscopically proven HAGL/pHAGL lesions. Radiol Res Pract. 2014:283575, 2014
                                                                                  3. Park KJ et al: A large humeral avulsion of the glenohumeral ligaments decreases stability that can be restored with repair. Clin Orthop Relat Res. 472(8):2372-9, 2014
                                                                                  4. George MS et al: Humeral avulsion of glenohumeral ligaments. J Am Acad Orthop Surg. 19(3):127-33, 2011
                                                                                  5. Taljanovic MS et al: Humeral avulsion of the inferior glenohumeral ligament in college female volleyball players caused by repetitive microtrauma. Am J Sports Med. 39(5):1067-76, 2011
                                                                                  6. Murphy DT et al: Humeral avulsion of the glenohumeral ligament. AJR Am J Roentgenol. 193(1):W74-5; author reply W76, 2009
                                                                                  7. Melvin JS et al: MRI of HAGL lesions: four arthroscopically confirmed cases of false-positive diagnosis. AJR Am J Roentgenol. 191(3):730-4, 2008
                                                                                  8. Bui-Mansfield LT et al: Humeral avulsion of the glenohumeral ligaments: the HAGL lesion. Am J Sports Med. 35(11):1960-6, 2007
                                                                                  9. Rhee YG et al: Anterior shoulder instability with humeral avulsion of the glenohumeral ligament lesion. J Shoulder Elbow Surg. 16(2):188-92, 2007
                                                                                  10. 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
                                                                                  11. Pouliart N et al: Simulated humeral avulsion of the glenohumeral ligaments: a new instability model. J Shoulder Elbow Surg. 15(6):728-35, 2006
                                                                                  12. Arciero RA et al: Mini-open repair technique of HAGL (humeral avulsion of the glenohumeral ligament) lesion. Arthroscopy. 21(9):1152, 2005
                                                                                  13. Spang JT et al: The HAGL lesion: an arthroscopic technique for repair of humeral avulsion of the glenohumeral ligaments. Arthroscopy. 21(4):498-502, 2005
                                                                                  14. Chhabra A et al: Arthroscopic repair of a posterior humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion. Arthroscopy. 20 Suppl 2:73-6, 2004
                                                                                  15. Richards DP et al: Arthroscopic humeral avulsion of the glenohumeral ligaments (HAGL) repair. Arthroscopy. 20 Suppl 2:134-41, 2004
                                                                                  16. Bui-Mansfield LT et al: Humeral avulsions of the glenohumeral ligament: imaging features and a review of the literature. AJR Am J Roentgenol. 179(3):649-55, 2002
                                                                                  17. Coates MH et al: Humeral avulsion of the anterior band of the inferior glenohumeral ligament with associated subscapularis bony avulsion in skeletally immature patients. Skeletal Radiol. 30(12):661-6, 2001
                                                                                  18. Bokor DJ et al: Anterior instability of the glenohumeral joint with humeral avulsion of the glenohumeral ligament. A review of 41 cases. J Bone Joint Surg Br. 81(1):93-6, 1999
                                                                                  19. Wolf EM et al: Humeral avulsion of glenohumeral ligaments as a cause of anterior shoulder instability. Arthroscopy. 11(5):600-7, 1995