Imaging Case of the Week 62

The following shoulder x-ray is from a 24 year old patient who presented with right shoulder pain following a direct fall onto his shoulder. He says his shoulder was dislocated, but after some manipulation, he was able to put it back in place prior to presentation. What can you see?

shoulder x-ray 2

click to enlarge

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The shoulder x-ray shown is not a proper AP view. The AP and lateral views showed no dislocation. However,  there is an irregular bony fragment lying below the humeral head with irregularity on the inferior aspect of the glenoid, suggesting an avulsion fracture of the glenoid.

This patient needs his shoulder immobilised in a sling and a referral to an orthopaedic outpatient clinic.

avulsion fracture of glenoid

click to enlarge



2 thoughts on “Imaging Case of the Week 62

  1. Is this considered a bony Bankhart lesion? And am I seeing a Hill Sachs lesion on the humeral head as well?

    Thanks in advance.

    • Thanks for the comments. Yes, that’s a bony Bankart’s due to avulsion fracture involving the inferior glenohumeral ligament. Also there is a Hill-Sach deformity involving the posterolateral humeral head.

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