[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Upper limb](https://durgical.com/en/anatomy/region/upper-limb/) › Humeral head cartilage [Skeletal system](https://durgical.com/en/anatomy/system/skeletal-system/) · [Upper limb](https://durgical.com/en/anatomy/region/upper-limb/) # Humeral head cartilage The humeral head cartilage is the smooth layer covering the ball of the shoulder; it lets the ball glide in the socket with almost no friction. Official name: Articular cartilage of the humeral head [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=upper_limb&select=cartilage_humeral_head&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The smooth layer covering the ball of the shoulder. ## What it does Lets the ball glide in the socket with almost no friction. ## Key points - The head is much larger than the glenoid, so only a small part of its cartilage touches the socket at any moment: the 'golf ball on a tee' that trades stability for range - Thickest at the centre of the head and thinner at its edge, the reverse of the glenoid cartilage; the mismatch makes the two surfaces fit more closely under load - Hill-Sachs lesion: a dent in the back, upper and outer head made by the glenoid rim in an anterior dislocation; a reverse Hill-Sachs on the front of the head follows a posterior dislocation ## Key facts **Where** Humeral head (anatomical neck margin up) **Function** Hyaline cartilage; smooth, low-friction joint surface; wears in osteoarthritis ## Relations **Deep** Subchondral bone of the humeral head; at its edge, the anatomical neck of the [humerus](https://durgical.com/en/anatomy/humerus/), where the [shoulder capsule](https://durgical.com/en/anatomy/shoulder-joint-capsule/) attaches **Medial** [Glenoid cartilage](https://durgical.com/en/anatomy/articular-cartilage-of-the-glenoid/) and the [glenoid labrum](https://durgical.com/en/anatomy/glenoid-labrum/), across the joint space **Above** [Long biceps tendon](https://durgical.com/en/anatomy/tendon-of-the-long-head-of-biceps/) arching over the head inside the joint, then the [supraspinatus tendon](https://durgical.com/en/anatomy/supraspinatus-tendon/) above the capsule **In front** [Subscapularis tendon](https://durgical.com/en/anatomy/subscapularis-tendon/), separated from it by the capsule and the [middle glenohumeral ligament](https://durgical.com/en/anatomy/middle-glenohumeral-ligament/) (MGHL) **Behind** [Infraspinatus tendon](https://durgical.com/en/anatomy/infraspinatus-tendon/) and [teres minor tendon](https://durgical.com/en/anatomy/teres-minor-tendon/), wrapping the back of the head ## How to find it It cannot be felt. At shoulder arthroscopy it is seen from the posterior portal, with the bare area and any Hill-Sachs dent on its back; in open surgery it comes into view through a deltopectoral approach once the [subscapularis](https://durgical.com/en/anatomy/subscapularis/) is detached or split. ## On imaging A true AP (Grashey) view shows the joint space as a clear gap and the outline of the head; an AP in internal rotation or a Stryker notch view shows a Hill-Sachs dent. MRI shows cartilage thinning, defects and bone oedema; CT measures the size and position of a Hill-Sachs lesion before surgery. ## Common problems - Shoulder osteoarthritis: the cartilage wears thin, causing pain, grinding and stiffness. - Cuff tear arthropathy: a large old rotator cuff tear lets the ball ride up and wear out. - Damage after repeated dislocations. ## How it is diagnosed X-rays show the narrowed joint space and bone spurs; CT plans surgery; MRI checks the rotator cuff. ## Treatment - Activity changes, pain medicines, physical therapy and sometimes injections. - Total shoulder replacement when the cuff is healthy; reverse replacement when the cuff is torn. ## Clinical notes - A large Hill-Sachs dent can catch ('engage') on the front of the glenoid in abduction and external rotation; together with glenoid bone loss it guides the choice of surgery, such as remplissage (filling the dent with [infraspinatus](https://durgical.com/en/anatomy/infraspinatus/)) or a bone block - Avascular necrosis and collapse of the head can follow anatomical neck or four-part proximal humerus fractures, which cut the supply from the [circumflex humeral arteries](https://durgical.com/en/anatomy/anterior-and-posterior-circumflex-humeral-arteries/) - Anatomic total shoulder arthroplasty resurfaces the head and glenoid when the rotator cuff works; a reverse prosthesis is chosen when the cuff has failed ## Development The head ossifies from its own secondary centre in infancy and later fuses with the centres of the greater and lesser tubercles; the proximal humeral physis beneath it closes in late adolescence and can be mistaken for a fracture line on X-ray. ## Related conditions - [Proximal humerus fracture](https://durgical.com/en/conditions/proximal-humerus-fracture/) ## Test yourself Think of the answer, then tap the question to see it. ## What is a Hill-Sachs lesion of the humeral head cartilage? A dent in the back, upper and outer humeral head made by the glenoid rim in an anterior dislocation. ## Where is the humeral head cartilage thickest? At the centre of the head, thinner at the edge: the reverse of the glenoid cartilage. ## Why can avascular necrosis of the humeral head follow anatomical neck or four-part fractures? These fractures cut the supply from the circumflex humeral arteries. ## When is a reverse shoulder prosthesis chosen instead of an anatomic one? When the rotator cuff has failed; anatomic replacement resurfaces head and glenoid when the cuff works. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/articular-cartilage-of-the-humeral-head/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** cartilago articularis capitis humeri TA2 382 **Official Spanish (DeCS)** Cartílago articular de la cabeza del húmero **English (TA2)** Articular cartilage of the humeral head ## Related - [Glenoid cartilage](https://durgical.com/en/anatomy/articular-cartilage-of-the-glenoid/) - [Humerus](https://durgical.com/en/anatomy/humerus/) - [Scapula](https://durgical.com/en/anatomy/scapula/) Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Glenohumeral Joint](https://www.ncbi.nlm.nih.gov/books/NBK537018/); [Anatomy, Shoulder and Upper Limb, Shoulder](https://www.ncbi.nlm.nih.gov/books/NBK536933/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/articular-cartilage-of-the-humeral-head/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/articular-cartilage-of-the-humeral-head/