Glenoid dysplasia

 A 50 year old lady presented with episodic feelings of instability in the left shoulder. Her radiographs show a dysplastic glenoid with superior and posterior decentering. 

An MRI showed that with the arm at the side, the humeral head was centered on the glenoid. This shows the effect of arm position on the degree of decentering. The posterior fibrous anlage of the glenoid is also seen on this image.

How should this shoulder be treated?

Interestingly enough this patient had no pain and essentially full active elevation as shown below. As a result, she will be followed with non-operative management.

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