Shoulder xray9/3/2023 Rotator cuff muscles: capsule of muscles and tendons that collectively stabilize the glenohumeral joint. With seizure activity, the internal rotator muscles (teres major and subscapularis) overpower the external rotator muscles (teres minor, infraspinatus) to dislocate the head of humerus.Ī posterior dislocation should be considered as a differential in any episode of shoulder pain and immobility after a seizure. When a bilateral posterior dislocation is present, it is almost always secondary to seizure activity. Dislocation may also result in capsulolabral tears, glenoid rim fractures or rotator cuff tears. If enlocation is delayed, it can worsen the severity of this lesion and lead to further complications. The force of the impact pushes the head of the humerus posteriorly out of the glenoid cavity.Īn impaction fracture of the anteromedial aspect of the humeral head (McLaughin lesion or reverse Hill-Sachs lesion) may result from the humerus being forced against the posterior lip of the glenoid. In traumatic posterior dislocations, the injury is almost always due to a fall onto an outstretched, internally rotated arm. Here will be limited to simple dislocations. Neck of humerus or fractures of the tuberosities. Often a posterior dislocation is accompanied by a fracture of the Traditionally posterior dislocations have been associated withĮpileptic seizures, high energy trauma, electrocution andĮlectroconvulsive therapy (ECT), although the incidence associated withĮCT especially has decreased somewhat in recent years. However because of a low level of clinical suspicion and insufficient imaging, they are often missed.Īpproximately half of posterior shoulder dislocations go undiagnosed on initial presentation. Posterior shoulder dislocations make up a small minority of total shoulder dislocation cases, accounting for 2-4% of presentations. What does these X-rays show? What signs do you look for on x ray for this condition? What other images would you order to confirm/rule out your diagnosis? Posterior Shoulder Dislocation Discussion
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