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Posterior shoulder dislocation

Case contributed by Ahmed Abdrabou
Diagnosis certain

Presentation

Shoulder trauma followed by pain and limitation of movement few months ago.

Patient Data

Age: 40 years old
Gender: Male

The humeral head is dislocated posteriorly and impacted against the posterior glenoid with a bony defect seen at its anteromedial surface (reverse Hill-Sachs lesion). Also there is avulsion of the greater tuberosity and pseudoarticulation with the glenoid.

Case Discussion

In posterior shoulder dislocation, the anteromedial aspect of the humeral head hits the posterior glenoid and becomes impacted posterior to it which is called Trough line sign in Plain radiograph. This crush results in bony defect of the anteromedial humeral head analogous to Hill-Sachs so that called Reverse Hill-Sachs sign. Also the posterior glenoid labrum is torn and considered Reverse Bankart lesion.

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