High Origin of the Anterior Band of the Inferior Glenohumeral Ligament

The anterior band of the inferior glenohumeral ligament (aIGHL) usually arises from anteroinferior labrum (below ~4 o’clock), but origins as high as 1 o’clock and from the middle glenohumeral ligament have also been described. These higher origins can mimic labral tears, variants (e.g., sublabral foramen and recess), or normal structures (e.g., spiral glenohumeral ligament) on MR imaging or MR arthrography to the uninitiated.

There may also be a relationship between the sites of attachment of the long head of the biceps tendon and the aIGHL. A study of ~100 cadavers suggested that a long head of the biceps attachment to the posterior labrum was associated with an aIGHL origin below the 4 o’clock position, while a biceps tendon attachment elsewhere was associated with a higher origin of the aIGHL. More recent work (10 cadavers) has not supported these results, however.

References

• Merila M, Leibecke T, Gehl HB, Busch LC, Russlies M, Eller A, Haviko T, Kolts I. The anterior glenohumeral joint capsule: macroscopic and MRI anatomy of the fasciculus obliquus or so-called ligamentum glenohumerale spirale. Eur Radiol. 2004 Aug;14(8):1421-6.
• Ramirez Ruiz FA, Baranski Kaniak BC, Haghighi P, Trudell D, Resnick DL. High origin of the anterior band of the inferior glenohumeral ligament: MR arthrography with anatomic and histologic correlation in cadavers. Skeletal Radiol. 2011 May 22.
• Tuoheti Y, Itoi E, Minagawa H, Yamamoto N, Saito H, Seki N, Okada K, Shimada Y, Abe H. Attachment types of the long head of the biceps tendon to the glenoid labrum and their relationships with the glenohumeral ligaments. Arthroscopy. 2005 Oct;21(10):1242-9.