Hill-Sachs lesion in recurrent shoulder dislocation: Sonographic detection

In a prospective study 61 patients with recurrent anterior shoulder dislocation were evaluated by sonography, radiography, and surgery to determine the value of sonography in the detection of a Hill-Sachs lesion. The group consisted of 57 male and four female patients with an average age of 27 years. Hill-Sachs lesion was found in 54 (88%) shoulders of the 61 surgically treated patients. Using surgical findings as the gold standard, we found sonography to be 96% (52 of 54 cases) sensitive, 100% specific (seven of seven cases), and 97% (59 of 61 cases) accurate in the diagnosis of Hill-Sachs lesion. The average size of the lesion measured by sonography was 19.2 mm long, 16.0 mm wide, and 4.1 mm deep. The lesion was of small or medium size (up to 6 mm deep) in 88% of patients. Results of our study show that sonography is a valuable imaging technique in the diagnosis of Hill-Sachs lesion. It produced only two false-negative results when compared with surgical findings.