E1904. If Your Shoulder Hurts, Raise Your Hand: Radiographic, CT and MRI Review of Anatomy and Dislocation Patterns of the Shoulder
Authors
Beatrice Knisely;
Henry Ford Health
Kyle Dammeyer;
Henry Ford Health
Chad Klochko;
Henry Ford Health
Gauthier Dongmo;
Wayne State University
Joseph Craig;
Henry Ford Health
Background
While shoulder trauma is a relatively common presentation for patients in the emergency and primary care settings some injury patterns are less frequent. Familiarity of imaging findings of acute trauma to the shoulder is critical for prompt diagnosis and treatment. Delay in appropriate care of acute shoulder injuries can lead to increased morbidity and loss of function in the affected shoulder. Rapid recognition of radiographic abnormalities in the acute setting is vital to clinical outcomes.
Educational Goals / Teaching Points
Review normal radiographic appearance of the shoulder on anterior-posterior, grashey, axillary, and scapular Y views. Correlative examples of anatomic landmarks with CT and MRI in concert with radiography. Overview of common mechanisms of injury of shoulder causing anterior subcoracoid, anterior subglenoid, pure inferior/luxatio erecta, and posterior shoulder dislocations. Review of relevant radiographic, CT, and MRI findings with the varied shoulder dislocation patterns. Pearls on the radiographic views that indicate deviation from normal anatomy. Review of the role of post reduction imaging.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Review of the normal anatomy of shoulder radiographs with emphasis on key anatomic findings. Radiographic findings of shoulder dislocations including anterior subcoracoid/subglenoid, inferior and posterior shoulder dislocations. Discussion of clinical management, importance of time to reduction, and post reduction imaging.
Conclusion
Imaging of acute shoulder trauma can aid in clinical management, decrease time to reduction, and improve patient outcomes. Rapid identification of normal landmarks aid in the interpretation of pathologic findings. We reviewed the normal appearance of shoulder radiographs with emphasis on key anatomic landmarks. We covered common mechanisms of injury for shoulder dislocations with their associated radiographic appearance. Finally we reviewed the utility of post-reduction imaging.
