Chronic anterior glenohumeral dislocation

Case contributed by Dr. Chris O'Donnell

Presentation

Prior history of melanoma with right axillary lymph node dissection. Now chronic right shoulder pain with limited range of movement. No recent trauma.

Patient Data

Age: 95
Gender: Male

Anterior GH joint dislocation with well-defined erosion and reactive rim sclerosis of the glenoid and humeral head.  Note surgical clips from previous LN dissection

CT for clatification of x-ray findings

ct

CT confirms glenoid erosion and reactive sclerosis with remodeling consistent with chronic dislocation rather than an acute Bankart fracture. The humeral head also shows reactive sclerosis with cortical bone loss.  Note surrounding soft tissue swelling/joint fluid and intra-articular bone fragmentation arising from the genoid rim and humeral head.

Case Discussion

Posterior shoulder dislocation is more commonly missed at clinical examination and can become chronic.  Anterior dislocation is more apparent clinically with palpable deformity and pain. In an older patient with chronic shoulder pain, however, dislocation can be missed following trauma with symptoms assumed to be due to osteoarthritis or rotator cuff disruption.

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