Diagnosis of Anterior Glenohumeral Instability.

Last updated Friday, January 28, 2005

Diagnosis of traumatic anterior glenohumeral insta

A. History

1. Mechanism of injury appropriate to cause tearing of the anterior glenohumeral ligaments, such as a major external rotation torque applied when the arm is elevated near the coronal plane
2. Functionally significant recurrent episodes of apprehension (fear of uncontrollable glenohumeral translations) or instability (inability to keep the humeral head centered in the glenoid fossa) when the arm is elevated near the coronal plane and externally rotated or extended

B. Physical examination

1. Apprehension or instability when arm is elevated near the coronal plane and externally rotated or extended
2. Diagnosis is supported by grinding with translation on anterior drawer test

C. Radiographs

1. Diagnosis is supported by radiographs documenting a previous anterior glenohumeral dislocation
2. Diagnosis is supported by radiographs showing a characteristic posterior lateral humeral head defect and/or anterior inferior glenoid lip defects or calcification.

The necessary and sufficient criteria for the diagosis of atraumatic glenohumeral instability are:

A. History

1. Functionally significant inability to keep the humeral head centered in the glenoid fossa, especially in positions not at the extremes of motion
2. Absence of mechanism of injury likely to tear glenohumeral ligaments or capsule
3. Spontaneous reduction of translations

B. Physical examination

1. Demonstration that certain glenohumeral translations duplicate the symptoms of concern to the patient
2. Diminished resistance to translation in multiple directions as compared to a normal glenohumeral joint

C. Radiographs

1. Absence of traumatic lesions