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Image challenge
Paediatric shoulder injury: don’t get sucked in!
  1. Peter Michael Kilgour1,
  2. Lesley Watson1,
  3. Marc Williams2
  1. 1 Emergency Department, Wythenshawe Hospital, Manchester, UK
  2. 2 Radiology, Wigan and Leigh Foundation Trust, Wigan, UK
  1. Correspondence to Dr Peter Michael Kilgour, Emergency Department, Wythenshawe Hospital, Manchester M23 9LT, UK; zchaak8{at}doctors.org.uk

Abstract

Clinical introduction A healthy 8-year-old boy presented to the ED with acute left shoulder pain. He had been playing football and his left arm was pulled by an opposition team member. He fell to the ground and landed on his left shoulder causing pain. On examination after analgesia, active and passive movement of the shoulder joint was possible in all directions but range of motion was limited by pain. There was no visible swelling or bruising throughout the shoulder girdle. A radiograph of the shoulder was obtained (figure 1).

Figure 1
Figure 1

Plain radiograph of the left shoulder.

Question What radiographic finding is seen for this patient?

  1. Glenohumeral lipohaemarthrosis.

  2. Acromioclavicular joint disruption.

  3. Intra-articular gas.

  4. Intra-articular loose body.

Question

  • paediatrics, paediatric emergency medicine
  • imaging, X-ray
  • musculoskeletal, soft tissue injury

https://doi.org/10.1136/emermed-2018-207987

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    Footnotes

    • Contributors PMK contributed to patient management, image editing, manuscript draft and subsequent revision. LW contributed to patient management, manuscript and image review. MW contributed to manuscript and image review.

    • Competing interests None declared.

    • Patient consent Obtained.

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