The humeral head is covered by hyaline cartilage forming a smooth articular hemisphere approximately 30 mm in radius. The articular surface faces medially, superiorly, and posteriorly in the anatomical position, with the retroversion angle averaging 20-30 degrees relative to the transcondylar axis.
The humeral head articular surface is the site of Hill-Sachs lesions from anterior shoulder dislocation, where the posterosuperior humeral head impacts the anterior glenoid rim. MRI and CT quantify Hill-Sachs lesion size and depth to determine whether it engages with the glenoid. Large engaging Hill-Sachs lesions require remplissage (infraspinatus tenodesis) or Latarjet procedure to restore stability. Avascular necrosis of the humeral head affects this surface first.
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