Dislocated Shoulder? X-ray Attached

I had a bad injury where it felt like my arm was yanked out of the socket..i went to ER had xrays of my spine and shoulder...I was told nothing and sent home with ib profen...i feel like im on my death bed with the pain.

I am going to see a specialist as the ER was no use in treating me...not even a sling or neck brace..

Does my shoulder look normal? it sure does not feel normal. Thanks for any advice and your time for replying to a person i need of help but has no where to currently turn. again thank you!

Originally Posted by pat0 I had a bad injury where it felt like my arm was yanked out of the socket..i went to ER had xrays of my spine and shoulder...I was told nothing and sent home with ib profen...i feel like im on my death bed with the pain. Fortunately it doesn't appear like there is any bony trauma or injury. What was your injury? I am going to see a specialist as the ER was no use in treating me...not even a sling or neck brace.. The upper arm is very interesting in that it completely held into place by muscles. The humerus (upper arm bone) has significant muscle, ligament attachments and it is likely one of these or other associated structures were damaged, especially if it was a subluxation. Was it a full dislocation? Because this would significantly guide future treatment. Your risk of another dislocation would be increased, thus physiotherapy is important. Does my shoulder look normal? it sure does not feel normal. Thanks for any advice and your time for replying to a person i need of help but has no where to currently turn. again thank you! Hmm, this definitely sounds like a issue that needs hands on treatment. Without seeing the soft tissue, and especially feeling it it is almost impossible to determine the joint integrity and specifically what the problem is. Also, have you had any neurological tests to clear any neurological complications when the arm was placed back into normal position?

As above, regards

Canuck Physio thank you for chiming in, i have been feeling it do a pop sound when i try ti lift the arm upwards..the pop is right in the shoulder...i have a makeshift sling holding it from moving..i type with one hand and try to make due with daily life since the injury.

I dont have coverage for a neuro but trying for an orthopedic in the area but they are booked. can they help or is this more nerve related?

This is one of 2 injuries i got from one very bad motion of dropping a 200 pound pallet off a loading dock..i bent over and lowered it with my left arm..it jerked me down and on relash of getting up my shoulder popped and spine kinked. but the ER is absolutely no help..didnt even say much they were too busy...i feel like its dislocated a slight bit but just dunno?

hi
usually after injury tissues are inflamed, try to keep it in free pain position, put some cold compress 10 min every 2,3 hours.
get well

Yarok yes, thank you. so far i have been keepiing in one position to keep the pain down, i still have not heard back about the x rays and have been icing the heck out of my back and shoulder....
Does it look dislocated in the xray? it feels like it but just dunno?

again. Thank you members for any advice.

Hi

as far as can see x ray is ok.but re dislocation probably that was dislocation, or maybe sprained generally saying injury. Then, hard things such bones, which u can see them in x-ray looks fine (my opinion). But soft tissues (muscles, tendons,ligaments,etc) serranding the joint are injured (overstretched, torn, bruised), and cant see in xray. Those (overstretched, torn, bruised), at beginning make immflamation (hot,tender, redish, pain, swollen etc) as a natural defensive reaction after (overstretched, torn, bruised).

When u get well (i think) the most important is analising why the shoulder is prone to injury, and implement proper rehab.

all the best

try to be checked again by a radiologist for any furher imaging advice...

looks like the rotators are involved on anterior-posterior view but you better make the lateral(side) view to rule out anterior dislocation. even the good side must be checked for comparison...anyway, im sure the pain has subsided with NSAIDs and putting in the position-of-comfort...
anyway, if you are not into sports or your occupation is not that demanding, i'd advice you to delay any exercises. just go on with your activities as your shoulder permits.
check physio near you to better evaluate you....

You need to see a physio for full physical assessment. X-rays tell next to nothing in this sort of injury.

Lot's of things could have happened, but only in-person assessment or MRI will tell you. You could have dislocated it, injured the attachment of your biceps onto the shoulder, torn a rotator cuff muscle...lot's of things, but again it needs a physical assessment.

I would agree with Dugal, you need to see a physio and have a full assessment. On top of the soft tissue injury you might have it is important to check the Brachial plexus and peripheral nerves.

Widespread area of pain, presence of pins and needles, numbness are some of the symptoms indicating involvement of the peripheral nervous system (PNS).

Definitely you are better off seeing someone in-person!

The films attached look as if the humerus is dislocated inferiorly. The space between the acromial arch and the head of the humerus is excessive. There isn't enough clinical information to make some kind of online diagnosis but possible rule out diagnoses include torn/ruptured supraspinatus tendon, capsular tear, as well as infraspinatus/subscapularis injury due to the apparent humeral positioning. See a physio and get lateral films.

Originally Posted by pat0 I had a bad injury where it felt like my arm was yanked out of the socket..i went to ER had xrays of my spine and shoulder...I was told nothing and sent home with ib profen...i feel like im on my death bed with the pain. I am going to see a specialist as the ER was no use in treating me...not even a sling or neck brace.. Does my shoulder look normal? it sure does not feel normal. Thanks for any advice and your time for replying to a person i need of help but has no where to currently turn. again thank you!

Can you tell me something more about the pain? What makes it worse? Can you move your arm forward and sideways? If you can't why? (pain, weakness How about reaching you back and your neck? Are you still on ibuprofen? Any improvement ?

Originally Posted by pat0 I had a bad injury where it felt like my arm was yanked out of the socket..i went to ER had xrays of my spine and shoulder...I was told nothing and sent home with ib profen...i feel like im on my death bed with the pain. I am going to see a specialist as the ER was no use in treating me...not even a sling or neck brace.. Does my shoulder look normal? it sure does not feel normal. Thanks for any advice and your time for replying to a person i need of help but has no where to currently turn. again thank you!

That sounds bad... how about MRI? It will tell you more about the status of your soft tissues. Any Shoulder instability test done? Xray images wont show much, better focus on clinical presentation. Check any pattern of limitations and pain.

Hi,

As far as the X-rays go i would say that its a subluxation and not dislocation of the joint.Further assessment must be done by a physio though.

Get well soon.
tc

Any news about the shoulder, whats the latest?

Originally Posted by pat0 I had a bad injury where it felt like my arm was yanked out of the socket..i went to ER had xrays of my spine and shoulder...I was told nothing and sent home with ib profen...i feel like im on my death bed with the pain. I am going to see a specialist as the ER was no use in treating me...not even a sling or neck brace.. Does my shoulder look normal? it sure does not feel normal. Thanks for any advice and your time for replying to a person i need of help but has no where to currently turn. again thank you!

Pato you say you had a bad accident. What sort of accident? In which position was your arm? what did you feel immediately after the accident? And where? Can you describe the pain you felt then and now? How long ago was the accident? What movements can you make with the arm? How is your neck? Without this information an answer is futile.
When it comes to the X-rays, they are taken from a position which makes it inconclusive to say if there is or has been a sublucation thinking that a anterior luxation is the most common. I agree with the remark that it appears to be luxated caudal (downwards) because the space win between the acromion and the caput of the humerus is to big. The AC joint seems to be in tact.
Best of luck.

Well, according to the x-ray there is definite/classic sign of soft tissue injury. The acromio-humeral space is exaggerated.
As the patient has pain, it will be advisable to rest the shoulder using an immobilizer and to prescribe over-the-counter NSAIDs.
Once the patient's pain score is better, he may be reassessed thoroughly to ascertain the injured soft-tissue structure and plan further management.

ya my arm feels like its been poppin in and out of the socket for some time now. i cannot sleep on that side anymore because the weight seems to push it out and i get a very painful raw feeling under my arm pit when i try to do a backstroke, also a pop everytime i raise the arm like a jumping jack postion....its a loud enough pop to hear a few feet away..so i hope the muscle will heal tight..i was squatting down and lowering a heavy object off a dock..the injured arm was pulled straight down when i let go with my other arm....very swollen so i iced it for days....my neck is torticollis i guess..common from what im told..secondary spasmadic torticolis was my Dx...


the doctors said my arm x-ray was fine...do i need a second opinion? he did not see my arm when it was swollen..or did not care about the poppin..feelin better lately tho.

Dear pat0,

Although it's kind of late that I reply to your post, I would like, firstly, to wish you get better soon and, secondly, to tell you my opinion about your injury.

First of all, no one can make a diagnosis online, since a face-to-face contact is mandatory in every case. I do think, though, that according to signs, symptoms and every detail a professional has about an injury, can lead him/her to some or a conclusion, without making a definite diagnosis.

So, concerning the x-rays, it seems like there is or have been a subluxation or dislocation, as there is a wider space between scapula's (shoulder blade's) acromion and head of humerus bone (some have already mentioned this). Whether this was anterior, inferior etc, it had to be determined in combination with a different view x-ray. Finding the direction of the subluxation/dislocation would be of importance, although some would disagree. The position of the sternoclavicular joint (between the clavicle-horizontal long bone from the shoulder to your chest- and the sternum- vertical chest bone at the front) is not shown in the x-rays you have attached. It would be interesting to check its position. It is not very likely, according to your symptoms, to have had an injury (sprain, subluxation or dislocation) at this joint, but it would worth assessing it at least by palpation. This joint is of high importance during rehabilitation and should be assessed by your physio. Neurovascular structures should also be assessed, although 3 weeks after your injury make me guess that they are intact.

Taking into account your symptoms (pain, difficulty in motion, a 'pop' at shoulder flexion), there is definitely concomitant soft tissue involvement (sprain, strain, tear etc). An x-ray cannot tell anything about it, so clinical tests and maybe MRI would give more details. Your shoulder seems like it is dislocated and put back on place often, which is not only painful but could also be dangerous for neurovascular tissues.

Therefore, you definitely have to visit another physician (firstly) and a physio (secondly) because reoccurrence of dislocation is not wanted. Medical diagnosis and physio assessment will help you recover quicker and safer.

I wish you again good and quick recovery. If you need more info, feel free to e-mail me.

Best wishes,
Ilias

Hi,

I agree with all of the above but the popping sound and the mechanism of injury can also indicate a tear of the labrum - the cartilage that helps to deepen the glenoid fossa.

Your XRays look like your shoulder is slipping downwards (as mentioned above). This could be because of ligament and/or muscle damage OR the cartilage was damaged and allowing the shoulder to "pop" out that way.

Otherwise good luck and let us know what is going on. BTW, MRI with arthrogram would be a nice investigation to have - even a CT arthrogram.

Cheers