shoulder instability pre-webinar cases
October 23, 2020
by orthohub
These cases are are to get you to start thinking and questioning your knowledge ahead of the webinar on shoulder dislocation / instability.
We are joined for this 360 degree educational event by:
Let’s get straight into it
A 22 year old male student and amateur weekend rugby player sustained an anterior dislocation tackling another player 1 week ago. His shoulder was relocated off pitch and he was placed in a sling. He comes to see you in fracture clinic. He is desperate to return to rugby. No previous shoulder problems.
X-rays were done after relocation:
He had an MR Arthrogram:
See takeaway video below next cast
A 22 year old male student and amateur weekend rugby player sustained an anterior dislocation tackling another player 1 week ago. His shoulder was relocated off pitch and he was placed in a sling. He comes to see you in fracture clinic. He is desperate to return to rugby. No previous shoulder problems.
X-rays were done after relocation:
The patient had a CT scan:
This is a 25-year old female who underwent an arthroscopic Bankart repair for recurrent anterior instability 3 years ago. She had considered her shoulder stable until 1 year ago, when she sustained a documented anterior dislocation whilst playing hockey. She returned to all sports but presents to the clinic having had a further ‘dislocation’ of her shoulder in her sleep. Her shoulder ‘re-located’ in the ambulance.
The patient goes on to have a CT scan.
22 year old sports science masters student who plays Gaelic football (which involves collisions +++!!)
He has had several subluxations following an arthroscopic shoulder stabilisation 2 years ago for presumed anterior instability only.
He reports that it has never been 100% since then and feels that the shoulder is stiff.
On examination there is restricted external rotation to 40 degrees Vs 80 on the good side. Rotator cuff has good strength. There is mid range apprehension, with positive relocation sign. O'briens and modified O'Briends are positive.
His buddy is a MRI technician and gets him scanned to see what's going on:
You decide to do an EUA and a shoulder arthroscopy. On EUA he is stiff (external rotation to 40 degrees), with grade II anterior and posterior instability. Pictures below:
Please post your thoughts about these cases in the comments section below.
For the answers to these questions and much more join our webinar this week, Wednesday 24th October at 8pm BST.
Nice idea...!!!
Great, glad you enjoyed them. Hope you enjoyed the webinar. Mike B
We think so! I hope it helped you consider the topics before and after the webinar. Mike B
Nice , stimulating cases!
Fantastic stimulating case ☕👍
Great, glad you enjoyed them. I hope you enjoyed the webinar too. Mike B
Awesome, glad you enjoyed them. Mike B
Thank you.