Korean J Sports Med.  2014 Jun;32(1):59-64. 10.5763/kjsm.2014.32.1.59.

Osteochondral Lesion of Humeral Head Associated with Shoulder Internal Impingement: Report of Three Cases

• Kim JB
• Park JS
• Hong CH
• Kwon SW
• Soh JW
• Nho JH
• Lee CJ

• KMID: 2288691
• DOI: http://doi.org/10.5763/kjsm.2014.32.1.59

Abstract

Internal impingement syndrome is characterized by the posterior shoulder pain when the arm is abducted and external rotated, and articular partial rotator cuff tear with posterosuperior labral fraying in throwing athletes. Osteochondral lesion of humeral head as an associated lesion is reported in some cases but, not considered to be a main origin of the symptoms. We found the similar features of osteochondral lesion on humeral head in three cases of internal impingement syndrome irrespective of conservative treatment for over three months and report good results obtained from arthroscopic debridement and microfracturing for these lesions with a review of the literatures.

Keyword

Humeral head; Chondromalacia; Impingement syndrome; Shoulder

MeSH Terms

Arm
Athletes
Cartilage Diseases
Debridement
Humans
Humeral Head*
Rotator Cuff
Shoulder Pain
Shoulder*

Figure

• 

  Fig. 1. (A, B) Coronal and sagittal magnetic resonance images show no significant osteochondral lesion of humeral head, but suspected lesion with low signal intensity as subchondral lesion (white arrow). (C) Arthroscopic finding shows posterosuperior labral fraying. (D) Arthroscopic finding shows intraarticular partial tear of supraspinatus tendon. But humeral head may seem like intact in 30o arthroscope viewing. (E) Osteochondral lesion of humeral head is confirmed by switching 70o arthroscope. (F) Arthroscopic debridement and microfracturing are performed.

• 

  Fig. 2. (A, B) Magnetic resonance images show a focal chondral defect on the superior aspect of humeral head with high signal intensity on T2-weighted images (white arrow). (C) Arthroscopic findings show posterosuperior labral fraying. (D) Arthroscopic finding shows osteochondral lesion of humeral head. (E) Arthroscopic debridement is perfomed.

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  Fig. 3. (A, B) T2-weighted magnetic resonance images show high signal intensity lesion suspected as a chondral lesion (white arrow). (C) Arthroscopic finding shows stable scratches on the posterior glenoid labrum (black arrows). (D) Arthroscopic findings show focal chondral lesion of humeral head. (E) Debridement and microfracturing are perfomed arthroscopically.

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