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<v Narrator>Here's a 21-year-old man with shoulder pain

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and let's start out with the most comfortable projection,

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namely the coronal, and we're looking

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at the typical area that you would see

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a sublabral foramen or sulcus,

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which kinda arcs along and follows the course

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of the glenoid.

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And that looks pretty organized, pretty smooth,

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and follows the course of the glenoid.

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Now as we course a little more posterior,

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we run into this large gap right here,

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and here it is in the saggital.

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There's that gap.

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This is a big sublabral hole or foramen

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because the patient really doesn't have

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much of a superior labrum,

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so that's common in this variation.

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If you look in the saggital projection,

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here's the middle glenohumeral ligament

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coming up and having a very high takeoff

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in this variation known as the Buford complex

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and here is the Buford variant or Buford complex.

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This large structure, we go up a little higher,

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looks like a big triangular thing.

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There's no well-defined separate superior labrum.

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Now we go down a little bit.

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We see glenohumeral ligament going one way,

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glenohumeral ligament going the other way,

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labrum coming back, so everything meets

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at the train station right here

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and it looks, again, like a big pseudo-mass.

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So we have one problem and that is, what's this?

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So when you're looking at these variations,

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you say to yourself, okay, is that a variant

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or is that pathology?

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Well, fortunately, we have this slightly expansile cyst.

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No, it's not fluid, because it's round,

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it's pushing on things around it,

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and it's dissected itself into the base

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of this cord-like MGHL, right there.

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Let's look at the coronal.

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We'll see the sulcus and then we'll go

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right into this cyst right here, this tear,

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and it's right at the base of this high-riding,

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cord-like MGHL, so this is what you get

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in a patient with a SLAP seven.

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You get involvement of the base of the MGHL.

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It happens to be a little bit higher in this case

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because the MGHL takes off higher

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as this Buford variation.

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You've got a cyst with it as a harbinger of the diagnosis

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and you've also got a large, sublabral hole

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which is part of the Buford complex

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or variation, SLAP seven.