Shoulder Pain
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History of Present Illness:
A 22-year-old male presents to the ED for right shoulder pain after rolling over in bed and hearing a crack. He says he has felt like the shoulder has gone out before but it always pops back in. He denies or other complaints
Vital Signs & Physical Exam:
Vital signs are normal. Physical exam is normal except for guarding of right shoulder
Initial Differential Diagnosis:
Relevant Test Results:
- Imaging: See below
QUESTIONS:
- What does the case image show?
- 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 with a light-bulb sign. For more about this, google it or click here
- What should you do next? Confirm with a scapular Y view (see below) or axillary view. Treat with pain meds then reduce. Consult ortho.
- 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: Reduced without sedation and sent for ortho follow-up