Season 5 Case 20

msk Jan 11, 2017

Case 20

History: shoulder pain.  

The doc only ordered 2 Views and the tech sent 2 images which looked almost identical. Here is one of them.

Diagnosis (and list at least 1 diagnostic clue)



Answer:

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Answer: posterior shoulder dislocation (see axillary below)

Clues:

1) both views look the same (internally rotated)

2) light bulb sign (humeral head looks like a light bulb)

3) loss of the normal half-moon overlap of the humeral head and the glenoid

4) irrregular posterior glenoid cortex c/w reverse “bony” Bankart

5) borderline “Rim sign” - widened glenohumeral distance (diagnostic is over 6mm, which this may be just under)

reference: https://radiopaedia.org/articles/posterior-shoulder-dislocation

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