EM REMS

This patient had a fall on his shoulder and had pain, deformity of the shoulder.  Here are his radiographs:

This is a simple radiograph of an anterior glenohumeral dislocation (shoulder dislocation).  One can see the importance of a good Y-view (second image)  or an Axillary view (not seen here).  These alternate views help determine if the shoulder is anteriorly or posteriorly dislocated.  Knowing this will help aid in proper reduction.

Lesson is:  always get two views with radiographs.  (mainly directed at early medical learners, forgive me if you experienced learners just yawned)

Author:  Russell Jones, M.D.

Left Inferior Glenohumeral Dislocation (Shoulder dislocation)

It is very important to develop an algorithm when looking at imaging, ekgs, etc.  In my routine evaluation of an xray the last thing I do is look at the bones.  In this image if one looks at the left shoulder you can see an inferior glenohumeral dislocation, otherwise known as luxatio erecta.  This was read by the attending radiology physician as no traumatic pathology.  As the ED physician I had the luxury of knowing the patient couldn’t adduct her arm and it was easily caught on xray.

Author:  Russell Jones, M.D.