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  1. Caterina Barberi1,2,
  2. Francesco Niccolai3,
  3. Lorenzo Di Mento3
  1. 1 Biomedical Sciences, HUNIMED, Pieve Emanuele, Italy
  2. 2 Emergency Medicine, IRCCS Humanitas Research Hospital, Rozzano, Italy
  3. 3 Traumatology Department, IRCCS Humanitas Research Hospital, Rozzano, Italy
  1. Correspondence to Dr Caterina Barberi, Biomedical Sciences, HUNIMED, Pieve Emanuele 20090, Italy; caterina.barberi{at}humanitas.it

https://doi.org/10.1136/emermed-2021-211377

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    Clinical introduction

    A 91-year-old obese man presented to our ED, having symptoms of severe pain and inability to move the right shoulder after falling against a parked car.

    Patient’s comorbidities included chronic obstructive pulmonary disease, chronic kidney disease, ischaemic and valvular cardiomyopathy, atrial fibrillation.

    Vitals were in range, except for marked tachypnoea. On inspection, the arm was held abducted and overhead. A marked protuberance was visible over the axillary area. Range of motion was extremely limited. No neurovascular deficits were apparent. A right shoulder X-ray was performed (figure 1).

    Figure 1

    Right shoulder: X-ray—anteroposterior view.

    Question

    According to findings in figure 1, what is the patient suffering from?

    1. Lytic osseous lesions secondary to occult lung cancer

    2. Posterior shoulder dislocation with acromio-clavicular diastasis

    3. Luxatio erecta humeri with scapular …

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    Footnotes

    • Contributors All contributors have had input and agree on the final manuscript. In particular: conception or design of the work: CB, FN. Data collection: CB, FN. Data analysis and interpretation: CB, FN, LDM. Drafting the article: CB. Critical revision of the article: FN, LDM. Final approval of the version to be published: CB, FN, LDM.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.