IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Bilateral posterior shoulder dislocation

Case contributed by Stan Buckens
Diagnosis certain

Presentation

Chronic shoulder complaints in teenager with history of epilepsy.

Patient Data

Age: 16 years
Gender: Male

X-ray at age 13 years

x-ray

At age 13 years, these radiographs show subtle, bilateral alteration of the relation between the humeral head an glenoid. No Y-views were obtained. The partial ossification of the bony structures further complicates the interpretation. 

MRI total body at age 15 years

mri

An MRI whole-body obtained for other reasons shows the bilateral posterior dislocation of the humeral heads on one of the slides. This was not appreciated at the time. 

X-ray at age 16 years

x-ray

At age 16 years, non-specific chronic complaints elicited a referral for repeat radiographs. In this instance, Y-views were obtained, unexpectedly showing bilateral posterior dislocation of the humeral heads. 

CT at 16 years

ct

A CT was acquired to confirm the diagnosis, showing again the bilateral posterior dislocation as well as bilaterally elevated lateral clavicles at the level of the acromioclavicular joint. 

Case Discussion

Posterior dislocation of the shoulder is rare. When it does occur, it is relatively frequently associated with tonic-clonic epileptic attacks and in this setting, it can occur bilaterally. This rare pediatric case demonstrates how persisting dislocation can become permanent, reshaping the glenohumeral and acromioclavicular joints. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.