ARRS 2022 Abstracts


E1060. Imaging of Traumatic Shoulder Injuries: Understanding the Surgeon’s Perspective
  1. Mike Bao; Beth Israel Deaconess Medical Center; Harvard Medical School
  2. Joseph DeAngelis; Beth Israel Deaconess Medical Center; Harvard Medical School
  3. Jim Wu; Beth Israel Deaconess Medical Center; Harvard Medical School
Traumatic shoulder fractures are common and can require surgical fixation. It is important to understand the preoperative imaging findings and anatomic considerations that help the surgeon determine which patients require surgery. It is equally important to recognize common postoperative complications for each type of hardware used.

Educational Goals / Teaching Points
The goals of this exhibit are to discuss the clinical, anatomic, and imaging features that determine the need for surgical treatment for common traumatic shoulder injuries; discuss the surgical approach to each shoulder injury including their normal postoperative radiographical appearance; and recognize postoperative complications related to various surgical hardware.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Fracture classification, common and novel surgical options, and postoperative complications will be individually reviewed with imaging correlates for fractures of the proximal humerus, clavicle, and scapula. Discussion of proximal humerus fracture will review the Neer classification and selection criteria for open reduction internal fixation (ORIF) versus arthroplasty. Neer and AO classifications for clavicle fractures will be shown. Review of scapular fractures will focus on ORIF for glenoid and coracoid fractures. Lastly, Rockwood classification and treatment options for acromioclavicular (AC) joint injury will be discussed. Postoperative complications are best assessed on imaging and can include neurovascular injury, periprosthetic fracture, infection, malunion or nonunion, surgical hardware migration, and chronic instability.

It is important for radiologists to be familiar with the imaging characteristics of various types of traumatic shoulder injuries in context of what the surgeon needs to know when considering surgical versus nonoperative management, as well as associated possible postoperative complications.