Posterior shoulder dislocation

Case contributed by Dr Bruno Di Muzio

Presentation

Fracture post fight? dislocation?

Patient Data

Age: 28-year-old

Right shoulder

Modality: X-ray

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

Modality: CT

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 haematoma. 

Modality: Ultrasound
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.
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Case Information

rID: 48996
Case created: 4th Nov 2016
Last edited: 13th Dec 2016
Tag: rmh
Inclusion in quiz mode: Included

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