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Image Challenge
Dimple on the shoulder after a ski injury
  1. Morteza Khodaee1,
  2. Armando Vidal2,
  3. Greg Gutierrez3
  1. 1 Department of Family Medicine, Division of Sports Medicine, University of Colorado Denver School of Medicine, Denver, Colorado, USA
  2. 2 Department of Orthopaedics, Division of Sports Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
  3. 3 Department of Family Medicine and Denver Health Medical Center, University of Colorado Denver School of Medicine, Denver, Colorado, USA
  1. Correspondence to Morteza Khodaee; Morteza.khodaee{at}ucdenver.edu

Abstract

Clinical introduction A 74-year-old woman was brought to the ski clinic shortly after a fall on her left shoulder while skiing. She did not remember the exact fall mechanism. She felt a popping sensation in her left shoulder and was unable to move her left arm due to severe pain. Her medical and social histories were unremarkable. On physical examination, she had a deformity in her left shoulder (figure 1). Her neurovascular examination was intact.

Figure 1
Figure 1

Photograph of the left shoulder on arrival showing an anterior ‘dimple’.

Question What is the most likely diagnosis of the injury?

  1. An acromioclavicular joint (ACJ) sprain (shoulder separation)

  2. A proximal humerus fracture

  3. A distal clavicle fracture

  4. A posterior glenohumeral dislocation

Question

  • fractures and dislocations
  • accidental falls

https://doi.org/10.1136/emermed-2016-206560

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    Footnotes

    • Competing interests None declared.

    • Patient consent The patient was consented.

    • Provenance and peer review Not commissioned; internally peer reviewed.