shoulder and upper arm
TRANSCRIPT
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Regional trauma
Shoulder and upper arm
Dr.Aftab Qadir
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Outline
Shoulder dislocation
Fractures
Rotator cuff injury
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Trauma-series x-rays
Glenoid AP view
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Trans scapular lateral view
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Axillary view
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1.Shoulder dislocation
anterior > 95%
posterior 2-4%
inferior (luxatio erecta) < 1%
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Plain Films
X-rays are sufficient in most cases
associated fractures/injuries
Hill-Sachs lesion
bony Bankart lesion
proximal humeral fractures
clavicular fracture
acromioclavicular joint disruption
acromial fracture
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Hill-Sachs lesions
Bankart lesion
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Posterior Shoulder Dislocation
Radiological signs on AP view:
Internal rotation of the humerus
Light bulb sign
The ‘rim sign’ – Widening of the glenohumeral
space
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Inferior shoulder dislocation
Radiographic features
The humeral head is displaced directly below the
glenoid fossa.
arm often in marked abduction (luxatio erecta).
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2.Acromioclavicular injury
Features include :
soft tissue swelling
widening of the AC joint
increased coracoclavicular distance
superior displacement of the distal clavicle
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4.Clavicular fracture
vast majority occur in the midshaft
fall onto an outstretched arm
common in very young and very old patients.
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5.Scapula fractures
uncommon injuries, representing ~3% of all
shoulder fractures.
high energy trauma
Requires trauma series views
associated with other injuries
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6.Humerus
fractured by excessive torsion or by a direct
blow.
The humeral neck is frequently fractured in
elderly patients following a fall into the shoulder.
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7.Supracondylar fracture
90% are seen in children younger than 10 years
commonly seen in boys
due to accidental trauma
Lateral and AP radiographs are usually sufficient
indirect signs indirect signs
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9.Medial epicondyle fracture
represent almost all epicondyle fractures
most common avulsion injury of the elbow
typically seen in children and adolescents
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10.Galeazzi fracture-dislocation
fracture of the distal radius with dislocation of
distal radioulnar joint
children, peak incidence of 9-12 years of age
Plain films , orthogonal views
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11.Monteggia fracture-dislocation
fracture of the ulna shaft and dislocation of the
radial head
image both the elbow and the wrist, and good
quality AP and lateral views are required.
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12.Rotator cuff tear
common causes of shoulder pain
Prevalence of tear increases with age
Acromiohumeral interval indicative of rotator cuff
tear or tendinopathy.
ultrasound may have up to 90% sensitivity and
specificity
Hyperintense signal area within the tendon on
T2W, fat-suppressed and GRE sequences
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Few Cases
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Thank You