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Glenohumeral Ligament Complex

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Description

(A) Schematic illustration of the anterior ligaments of the shoulder. SGHL: superior glenohumeral ligament, MGHL: middle glenohumeral ligament, IGHL: anterior band of the inferior glenohumeral ligament, spiral GHL: spiral glenohumeral ligament. (B) Sagittal oblique MR arthrogram image shows the fasciculus obliquus (thick white arrows, B), the frenula capsulae (synovial bands) (thin white arrows, B) and the middle glenohumeral ligament (black arrows, B)[1]
A typical shoulder joint with the superior, middle and anterior-band of the inferior glenohumeral ligament (SGHL, MGHL and AB-IGHL) insertion areas shown. The posterior-band of the inferior glenohumeral ligament (PB-IGHL) is not shown for clarity.[2]
The ligaments of the shoulder joint[3]
Ligaments of the anterior shoulder joint[4]

General

  • There are 3 glenohumeral ligaments on the anterior side of the shoulde rjoint
  • They are thickening of the glenohumeral joint capsule
  • Important passive stabilizers of the joint

Superior Glenohumeral Ligament

  • Origin: superior aspect of the glenoid, coracoid process
  • Insert: superior part of the lesser tubercle of the humerus at the medial edge of the intertubercular fossa
  • Fibers are initially oriented anteriorly, then anteroinferior along the long head of the biceps tendon
  • Stabilizes the biceps brachii tendon[5]

Middle Glenohumeral Ligament

  • Origin: anterosuperior glenoid (just inferior to the superior GHL)
  • Insert: anterior proximal humerus at the base of the lesser tubercle (below the superior GHL attachment)

Inferior Glenohumeral Ligament

  • Sometimes called "inferior glenohumeral ligament complex"[6]
  • Origin: inferior two-thirds of the glenoid labrum
  • Insert: inferior aspect of the anatomical humeral neck
  • Three components
    • Anterior band
    • Posterior band
    • Axillary pouch (Between anterior and posterior bands)
  • Function
    • Prevents dislocation at the extreme range of motion
    • Main stabilizer of the abducted shoulder

Spiral Glenohumeral Ligament

  • Also called: fasciculus obliquus[7]
  • Origin: infraglenoid tubercle, triceps tendon
  • Insert: lesser tubercle of humerus, shared insertion with subscapularis tendon
  • Not well understood, but consistently seen on anatomic dissection and MR arthrography

Variant Anatomy

  • Superior GHL is almost always present (97% ref), has variable origin
    • Arises with biceps brachii tendon[8]
    • Arises with middle GHL
    • May be thickened in the setting of an absent/hypoplastic middle GHL
    • May be absent in the setting of a Buford complex[9]
  • Middle GHL is variable in size and appearance 1 and absent in 30%
    • Forms part of the Buford complex

Clinical Significance

  • Humeral avulsion of the glenohumeral ligament (HAGL)
  • Bony humeral avulsion of the glenohumeral ligament (BHAGL lesion)
  • Glenoid avulsion of the glenohumeral ligament (GAGL)
  • Bennett lesion
  • Buford Complex
  • Glenohumeral Instability
  • Glenohumeral Dislocation

See Also

References

  1. ↑ Kadi, Redouane, Annemieke Milants, and Maryam Shahabpour. "Shoulder anatomy and normal variants." Journal of the Belgian Society of Radiology 101.Suppl 2 (2017).
  2. ↑ Massimini, Daniel F., et al. "In-vivo glenohumeral translation and ligament elongation during abduction and abduction with internal and external rotation." Journal of orthopaedic surgery and research 7 (2012): 1-9.
  3. ↑ Image courtesy of teachmeanatomy.info
  4. ↑ Image courtsey of orthobullets.com
  5. ↑ Philip Robinson. Essential Radiology for Sports Medicine. (2010) ISBN: 9781441959720
  6. ↑ Charles A. Rockwood. The Shoulder. (2009) ISBN: 9781416034278
  7. ↑ Merila M, Leibecke T, Gehl HB et-al. The anterior glenohumeral joint capsule: macroscopic and MRI anatomy of the fasciculus obliquus or so-called ligamentum glenohumerale spirale. Eur Radiol. 2004;14 (8): 1421-6.
  8. ↑ Motamedi D, Everist B, Mahanty S, Steinbach L. Pitfalls in Shoulder MRI: Part 1—Normal Anatomy and Anatomic Variants. AJR Am J Roentgenol. 2014;203(3):501-7.
  9. ↑ Hantes M & Raoulis V. Arthroscopic Findings in Anterior Shoulder Instability. Open Orthop J. 2017;11(1):119-32.
Created by:
John Kiel on 12 December 2024 20:59:25
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Last edited:
12 December 2024 21:38:59
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