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ALPSA lesion Medial displacement with inferior shifting. Hard to tell sometimes if the periosteum is intact, which is the way it was originally described. The key to the diagnosis on MRI is medial and inferior displacement. Acutely, no crime if called a bankart lesion as the arthroscopist will see it and know what to do. Chronically with healing and resynovialization there may be misdiagnosis of no avulsion.