History: pain/swelling/deformity (you know, our favorite)
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Case 34 Answer
I could have given you the other rotation. Harder? Confirm your suspicion?
Answer: posterior shoulder dislocation
Relatively fixed internal rotation (lightbulb sign), trace overlap of the humeral head with the glenoid (absent half-moon sign), and suggestion of a trough defect (aka reverse Hill Sachs deformity) on the prior image.
anterior dislocation = Hill Sachs (both WAAAYY more common), and sometimes a Bankart injury (technically ONLY the labrum - vs anterior glenoid fracture which includes the bone and termed by some a “bony Bankart”)
posterior dislocation = trough sign (aka reverse Hill Sachs) and sometimes a posterior glenoid injury