Presentation
Left shoulder region injury due to a fall on the ground one week before the presentation. Initial immobilization was done without a radiograph. The patient was referred for an ultrasound due to persistent abduction weakness.
Patient Data
There is a fracture of the proximal humerus metaphyseal region with displacement as seen in the anterior, lateral, and posterior long axis scan planes. The periosteum is elevated due to the subperiosteal hemorrhage.
The rotator cuff is normal. There is no effusion in the glenohumeral joint or subacromial-subdeltoid bursa.
Xray was done after US showed a humerus fracture.
There is a fracture of proximal humerus metaphyseal region. There is no bone lesion/ dislocation.
Case Discussion
A girl had a fall on the ground resulting in the left shoulder region pain. Ultrasound was the first investigation at the end of one week showing a proximal humerus fracture. Later a radiograph was done which showed a fracture.
The case is an example of an inappropriate investigation. Xray should be done first in case of a trauma like this. There would have been no need for an ultrasound if an x-ray was done prior.