# Woman With Shoulder Pain: Posterior Shoulder Dislocation Diagnosed With Point-of-Care Ultrasound

## TL;DR

A woman with shoulder pain had a rare posterior shoulder dislocation diagnosed using ultrasound in the emergency room.

## Contribution

The study highlights the effectiveness of point-of-care ultrasound in diagnosing posterior shoulder dislocations.

## Key findings

- POCUS demonstrated higher sensitivity and specificity than X-rays for diagnosing shoulder dislocations.
- Computed tomography confirmed the posterior shoulder dislocation diagnosed by ultrasound.
- POCUS is recommended as an efficient diagnostic tool in emergency settings for such cases.

## Abstract

Posterior shoulder dislocations are relatively rare. When used by emergency medicine physicians, point-of-care ultrasound (POCUS) demonstrates higher sensitivity and specificity for diagnosing shoulder dislocation as compared to two-view plain films.

A 49-year-old woman presented to the emergency department (ED) with left shoulder pain following a mechanical fall. Physical examination was remarkable for a gross shoulder deformity and tenderness over the left proximal humerus. POCUS of the left shoulder using a curvilinear probe and a posterior approach was performed and demonstrated posterior displacement of the humeral head relative to the glenoid. Anteroposterior and oblique shoulder X-rays were read as unremarkable by the radiologist; a computed tomography of the shoulder confirmed a posterior shoulder dislocation.

Given its efficacy and efficiency as compared to X-ray radiography, POCUS should be strongly considered in the diagnosis and management of posterior shoulder dislocations in the ED setting.