Case 7

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© Springer Nature Switzerland AG 2020
C. G. Kaide, C. E. San Miguel (eds.)Case Studies in Emergency Medicinehttps://doi.org/10.1007/978-3-030-22445-5_36



36. Radiology Case 7



Caitlin Hackett1   and Joshua K. Aalberg1  


(1)
Department of Emergency Medicine, Wexner Medical Center at The Ohio State University, Columbus, OH, USA

 



 

Caitlin Hackett



 

Joshua K. Aalberg (Corresponding author)



Keywords

Anterior shoulder dislocationsHumeral headAnteriorlyInferiorlyMedially



Case 7a Indication for Exam


19-year-old male wrestler presents with shoulder pain during a match. The right shoulder is painful with a low lying humeral head and the arm held in slight abduction and internally rotated.


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Radiographic Findings


Humeral head is displaced anteriorly, medially, and inferiorly compatible with anterior subcoracoid glenohumeral dislocation.



Diagnosis


Anterior Shoulder Dislocation



Case 7b Indication for Exam


26-year-old male presents with shoulder pain after an assault. The left shoulder is painful, deformed, and fixed in internal rotation.


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Radiographic Findings


The AP view shows widening of the glenohumeral joint. The scapular Y view shows posterior displacement of the humeral head relative to the glenoid compatible with posterior dislocation.



Diagnosis


Posterior Shoulder Dislocation


Learning Points



Priming Questions






  • How are anterior and posterior dislocations different?



  • What are the common associated injuries?



  • Does the management differ for anterior vs. posterior dislocations?


Introduction


The shoulder is the most commonly dislocated joint in the body.



  • Anterior shoulder dislocations account for 95% of shoulder dislocations. In those cases, the humeral head is displaced anteriorly, inferiorly, and medially. The peak age is 15–25 years, and it is more common in males. The four types of anterior dislocation are subcoracoid, subclavicular, subacromial, and intrathoracic. [1]



  • Posterior shoulder dislocations account for 2–4% of glenohumeral dislocations. The humeral head usually dislocates straight posteriorly (subacromial). Rarely, the humeral head may dislocate subglenoid or subspinous. The peak age is 35–55 years, and it is more common in males. It can occasionally be bilateral depending on the mechanism [2].

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Mar 15, 2021 | Posted by in EMERGENCY MEDICINE | Comments Off on Case 7

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