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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?

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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.

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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.

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Continue to NEXT page for part III

 

 

Comments   

# Hueydoc 2011-08-26 19:08
No response from the orthopedist ?
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# Sharon 2011-08-27 04:46
I feel that "he exact mechanism of shoulder subluxation in association with septic arthritis is not yet known. It has been theorized that expansion of the glenohumeral capsule and the closely associated ligaments from accumulation of pus and fluid leads to joint instability", is a great synopsis. I hope that this report will help many physicians. <-)iv style="overflow :hidden">< ;-)iv style="height:4 0px"><-)i v> < /div><p&g t; </p& gt;<h2>on line casino ervaringen</ h2><p> <span>The re are more casino games added to this <a href ="http://www.ht mlwijzer.nl"> ;online casino ervaringen</ a> all the time and I will spend my gambling time and monies here from now on.</span> ;</p>< /div></di v>
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# DRLast Laugh 2011-10-30 19:56
This just proves the need for your parasitic colleagues. This type of negligence of emergency physician could be averted if a highly trained radiologist reviewed the plain film.
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