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Abstract
Paralabral cysts of the shoulder are rare, and there are few reports available that describe antero-inferior paralabral cysts arising from a detached antero-inferior glenoid labral tear without shoulder instability. We report an anteroinferior labral tear without shoulder instability in adolescent overhead athlete associated with paralabral cyst that leads to axillary nerve neurapraxia. Although nonoperative management of such labral lesions may provide symptoms of relief, it may not be enough for the athlete to return to the game. However, surgical treatment in this case provides successful recovery and rapid return to playing baseball play without having to worry about the progression of muscle denervation.
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Fig. 1.
Axial T2-weighted fat-suppressed (A, B), coronal T2-weighted fat-suppressed (C) and sagittal T2-weighted fat-suppressed (D) magnetic resonance images of the right shoulder. They are demonstrating an antero-inferior labral tear (from the 4-o’clock to 5-o’clock position) with adjacent 13 mm×15 mm×12 mm multiloculated paralabral cyst (from the 5-o’clock to 6-o’clock position) not extending into the quadrilateral space.
Fig. 2.
Coronal T2-weighted fat-suppressed (A) and sagittal T2-weighted fat-suppressed (B) magnetic resonance images of the right shoulder. Where denervation edema or teres minor mild atrophy was appreciated due to mild increased signal intensity (white arrows).
Fig. 3.
Arthroscopic view of the right shoulder with use of the superior portal (lateral decubitus position). (A) Arthroscopic findings showed that the antero-inferior capsule-labral complex had partial detachment (from the 4-o’clock to 6-o’clock position) from the glenoid. (B) The cyst and its multiloculated subcompartments were thoroughly decompressed under direct vision with blunt instruments and a shaver device. Then the anteroposterior margin of the glenoid was freshened and decorticated with the use of a shaver device. (C) Anatomic arthroscopic repair of the antero-inferior labral complex to the glenoid margin was performed with the use of two Bio Mini-Revo suture anchors (ConMed Linvatec, Largo, FL, USA) with one placed at the 4:30-clock position and one placed at the 5:30-clock position. A simple suture configuration was utilized.
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