Shoulder dislocation with bony Bankart lesion

Case contributed by Nathan McOrist
Diagnosis almost certain

Presentation

Presented to the emergency department with right shoulder pain after falling. Attempted to grab rail to catch fall.

Patient Data

Age: 35 years
Gender: Male

Initial x-rays

x-ray

Internal rotation and anteroinferior displacement of the humeral head in relation to the glenoid fossa represent an anterior shoulder dislocation.

No acute fracture is seen.

Images obtained post reduction

x-ray

Images obtained post-reduction.

There is an interval successful reduction of the glenohumeral joint. There is a bony Bankart lesion on the inferior aspect of the glenoid fossa, which was not appreciated on pre-reduction views.

There is also the impression of a Hill-Sachs depression on the superior aspect of the humeral head, which was confirmed on cross-sectional imaging.

Case Discussion

This case emphasizes the importance of assessing for these common findings when reporting shoulder dislocations, as they may not be completely apparent on the initial imaging views.

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