Author: Yasmin Sultan / Editor: Fiona Mendes / Reveiwer: Yasmin Sultan / Codes: ELP5, ELP9, SLO4, TC2, TP7Published: 01/07/2021

A 92-year-old man attends the emergency department complaining that his right shoulder “looks a funny shape”. He says he noticed it this morning. It is not painful but he is having difficulty raising his arm, for example when dressing or eating.

He had a couple of falls “some time ago”, but is unable to give any other history. He lives in a residential home and has no medical history other than an NSTEMI.

Relocation, relocation, relocation clinical image

On examination, his shoulder appears as shown in the photograph. There is no pain on either palpation or movement of the shoulder. Internal and external rotation are well preserved, but flexion and abduction of the shoulder are limited to about 45 degrees.

On full external rotation of the shoulder, the dislocation appears to reduce, but it dislocates again once the arm is returned to a neutral position.

A x-ray of the right shoulder is performed (shown).

Glenoid defect - relocation