Imaging Case of the Week 290 Answer

The AP view of the left shoulder demonstrates a light bulb appearance of the humeral head. Y view obtained showed a posterior dislocation of the head of humerus.

Posterior shoulder dislocation is rare. Main risk factors are seizure and electrocution. Trauma is another cause.

A key finding on the AP view is symmetrical appearance of the head of the humerus referred to as ‘light bulb sign’. Another cause of symmetrical appearance on AP shoulder x-ray is extreme internal rotation of the shoulder in the absence of dislocation. So, a second view (either Y view or axillary view) should be obtained to confirm dislocation.

Reference: Grainger and Allison’s Diagnostic Radiology, 6th edition.


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