Acute posterior shoulder dislocation (ultrasound)

Case contributed by Chris Newman

Presentation

? Rotator cuff injury. Pt presented to emergency last evening with normal shoulder XR following a fall

Patient Data

Age: 50 years
Gender: Female
  • the humeral head is posteriorly centered relative to the glenoid in keeping with a posterior dislocation
  • glenohumeral joint effusion with fluid tracking along the long head of biceps tendon sheath
  • the rotator cuff tendons are generally heterogenous and are difficult to assess in the setting of suspected glenohumeral joint dislocation
  • posteriorly translated humeral head relative to the glenoid in keeping with a posterior dislocation
  • the glenohumeral joint has been relocated
  • focal depression of the anterior humeral head in keeping with a reverse Hill-Sachs lesion
  • no osseous defect / Bankart injury to the posterior glenoid

Case Discussion

Posterior shoulder dislocation is not commonly diagnosed on ultrasound as is usually easily seen on x-ray.

This patient presented to our outpatient ultrasound department having had an x-ray at another institution, which was reported as normal.

She then went to have confirmatory x-rays at our institution as well as a subsequent post-reduction CT, which showed the reverse Hill-Sachs defect.

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