Motorcycle Crash
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History of Present Illness:
A 42-year-old male presents to the ED for shoulder pain after a motorcycle accident. He denies any neck or back pain, chest or abdominal pain or other complaints. He was wearing a helmet and full leather gear.
Vital Signs & Physical Exam:
Vital signs are normal. Physical exam shows tenderness and decreased range of motion to the left shoulder
Initial Differential Diagnosis:
- AC separation
- Clavicle fracture
- Shoulder dislocation
- Shoulder fracture
- Syphilis, the great imitator
Initial Diagnostic Testing:
- Imaging: See Below
QUESTIONS:
- What does the case image show? (click two times to enlarge)
- What should you do next?
- Want a 1-minute consult/tutorial on this case?
- Want to know what happened with this patient?
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ANSWERS:
- What does the case image show? The image shows a posterior shoulder dislocation. See the axial view below.
- What should you do next? Reduce it
- Want a 1-minute consult/tutorial on this case? See yellow area from sample page below.
- Want to know what happened with this patient? See case conclusion below tutorial page.
1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook
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CASE CONCLUSION: He went home
CASE LESSONS: This is super rare. Only seen one legit one in 20 years. Also have seen two fakers and one likely spontaneously reduced one after a seizure with a greater tuberosity fracture.