Reverse Hill-Sachs lesion
History of electric shock to the left upper limb about one week back. Shoulder pain significantly reduced during one week. Patient denies the history of dislocation.
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Biceps long head tendon is normal in position and shows normal echo pattern. Supraspinatus, infraspinatus, subscapularis tendons show normal echo pattern without a tear.
There is a wedge defect in the anteromedial aspect of the humeral head; deep to subscapularis tendon.
There is no subacromial-subdeltoid bursal effusion.
The young male had an electrocution to the left upper limb. Electrocution is a cause of posterior shoulder dislocation. Clinically there was no dislocation at the time of presentation to an orthopedic surgeon. Patient denies the history of dislocation.
Ultrasound shows intact rotator cuff. However, there is a defect in anteromedial aspect of the humeral head; deep to subscapularis tendon. It is an impaction fracture due to posterior dislocation which must have been transient at the time of injury.
- Ultrasound of the Musculoskeletal System S. Bianchi & C. Martinoli 1st Indian Reprint 2007.