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40 year old chronic shoulder pain

Findings, DDx? Additional studies / views?
Possible confirmatory view
What view is this? Final Dx? Mechanism?
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Answers
Posterior shoulder Dislocation
  • Initial image appears almost normal, except for the sclerosis in the medial portion of the humeral head (“Reverse Hill-Sachs” lesion)
  • The Axillary Lateral view shows a complete dislocation posteriorly
  • Note that the posterior Dislocation is uncommon (~3% of shoulder Dislocations)
  • Easily missed; up to 50% of cases not recognized initially
  • Typically causes include electrical shock, convulsive seizures
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