[Multidirectional instabilities and hyperlaxity of the shoulder]

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Radiology

Background:

• Multidirectional instability (MDI) of the shoulder is an uncommon condition often overlooked.
• It is characterized by capsular distension and inferior glenohumeral ligament damage, leading to inferior instability.
• Diagnosis can be challenging, requiring thorough evaluation.

Purpose of the Study:

• To highlight the diagnostic challenges of multidirectional shoulder instability.
• To emphasize the importance of detailed clinical and radiological assessment.
• To outline diagnostic and treatment strategies for MDI.

Main Methods:

• Detailed clinical examination, potentially under general anesthesia, to determine instability direction.
• Radiological assessment including conventional and CT arthrography.
• Review of anatomical lesions associated with MDI.

Main Results:

• Capsular distension and inferior glenohumeral ligament damage are key anatomical findings.
• Multidirectional instability diagnosis relies on specific clinical and radiological evidence.
• Conventional and CT arthrography are valuable for diagnosis and treatment planning.

Conclusions:

• Multidirectional shoulder instability requires a high index of suspicion and meticulous diagnostic workup.
• Conservative management is the recommended first-line treatment.
• Surgical options, such as bone grafting and capsulorraphy, are considered when conservative measures fail.