Presentation
Healthy volunteer. Normal scan for teaching purposes.
Patient Data
Key: humeral head (HH), glenoid labrum (L), glenoid (G), infraspinatus (IS), deltoid (D)
Transverse/oblique view inferior to the scapular spine, left shoulder, probe marker lateral
Demonstration of limited, one view sonographic screening exam for shoulder dislocation:
- humeral head is in close apposition to glenoid
- internal/external rotation demonstrates rotational articulation maintained
No evidence of anterior/posterior shoulder dislocation or subluxation.
Case Discussion
A one view, point-of-care ultrasound exam may allow for rapid diagnosis of both anterior and the far more uncommon posterior shoulder dislocation in conjunction with shoulder radiographs. Ultrasound may also allow for dynamic assessment of reduction success prior to formal post-procedural radiographs, as well as the ability to deliver intra-articular local anesthetics if necessary.
Several approaches have been described, including lateral, anterior, and posterior one view assessments; this case depicts normal anatomy using the posterior approach, with the transducer under the spine of the scapula. The humeral head seated in close apposition to the adjacent glenoid, as well as the persistence of articulation throughout internal and external rotation supports, within the confines of this limited screening exam, the absence of a shoulder dislocation.