Bilateral chronic posterior shoulder dislocation

Case contributed by Dr Stan Buckens

Presentation

Chronic shoulder complaints in teenager with history of epilepsy.

Patient Data

Age: 16 years
Gender: Male
X-ray

X-ray at age 13 years

At age 13 these images 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

MRI total body at age 15 years

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

X-ray at age 16 years

At age 16, 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

CT at 16 years

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. 

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Case information

rID: 39213
Case created: 25th Aug 2015
Last edited: 5th Sep 2016
Inclusion in quiz mode: Excluded

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