Posterior shoulder dislocation

Case contributed by Bruno Di Muzio
Diagnosis certain


Fracture post fight? dislocation?

Patient Data

Age: 30 years

Right shoulder


The right humeral head is posteriorly subluxated or dislocated relative to the glenoid. Depression of the medial aspect of the humeral head suggestive of a reverse Hill-Sachs lesion. 'Lightbulb' appearance of the humeral head suggests an internal rotation of the humeral head. 

CT Right shoulder


The right glenohumeral joint has been dislocated posteriorly. The anterior aspect of the humeral articular surface has become impacted on the posterior aspect of the bony glenoid, resulting in a reverse Hill-Sachs lesion. There is a tiny osseous fragment posterior to this, with probable donor site from the glenoid, indicating a reverse bony Bankart lesion. No other fracture. No significant surrounding soft tissue hematoma. 


The rotator cuff is intact. Long biceps tendon is located. The reverse Hill- Sachs lesion is identified, and no attenuation or gap in the overlying subscapularis musculotendinous junction is shown. No joint effusion. Acromioclavicular joint is unremarkable.

Case Discussion

Posteriorly dislocated right shoulder with reverse Hill-Sachs and reverse bony Bankart lesions.

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