Posterior shoulder dislocation

Case contributed by Alexandra Stanislavsky

Presentation

Left shoulder pain after pushing a heavy object.

Patient Data

Age: 10 years
Gender: Female
x_ray

There is lack of overlap between the glenoid and the humeral head. The shoulder is rotated such that the humeral head has a 'light bulb' appearance. 

x_ray

Both the lateral and especially the axillary view clearly demonstrate the relationship between the glenoid and the humeral head, and confirm a posterior dislocation.

Annotated image

On both views the acromion (A), clavicle (Cl), coracoid process (Co) and glenoid (G) are identifiable, and the humeral head can be seen lying posterior. 

The patient went on to have closed reduction in the emergency department. 

x_ray

Post reduction film demonstrate the anterior rim of the glenoid and humeral articular surfaces appearing congruent.

Annotated image

Dislocation film demonstrates no congruency between the glenoid articular suface (blue) and that of the humeral head (yellow). In addition due to internal rotation the proximal humeral head has a rounded appearance, likened to a light bulb (light green). 

Post reduction film demonstrate the anterior rim of the glenoid (blue) and humeral (yellow) articular surfaces appearing congruent.

Case Discussion

Typical appearances of a posterior shoulder dislocation, demonstrating the relatively subtle AP findings. 

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