The X-ray from the previous page demonstrates an inferiorly subluxed humerus. No fractures are apparent. Soft tissues are unremarkable. The patient was sedated with Etomidate and the shoulder was reduced. See post-reduction films below, top. A chest X-ray was also obtained at this time to rule out pneumonia given unexplained fever.
What do you see?

The figure above demonstrates interval reduction of the right shoulder joint. There is mild widening of the right glenohumeral joint space likely representing underlying effusion. No other fracture or dislocation is seen.

This CXR was obtained only a minute after the post reduction right shoulder films and demonstrates an inferiorly subluxed right humeral head. The orthopedic specialist was contacted regarding concern for an unstable shoulder. He recommended placing the patient in a sling and swath and obtaining a repeat X-ray of the shoulder. Repeat shoulder films revealed an inferiorly subluxed right shoulder (below).
The orthopedic specialist was again notified and at this time came into the ED for evaluation of the shoulder.

Continue to NEXT page for part III