Question

Kathy, age 49, has recently begun a rigorous weight-lifting program. She presents to your clinic with a shoulder dislocation. Which of the following clinical manifestations make you suspect an anterior shoulder dislocation over a posterior dislocation?

1) Pain and tenderness in the front of the shoulder
2) Limited range of motion in external rotation
3) Visible deformity in the back of the shoulder
4) Pain and tenderness in the back of the shoulder

Answer 1

An anterior shoulder dislocation likely presents with pain and tenderness in the front of the shoulder and limited external rotation. For Kathy, experiencing these symptoms suggests this type of dislocation rather than a posterior one, which would show different clinical signs.

Step-by-step explanation:

To suspect an anterior shoulder dislocation over a posterior dislocation in a patient like Kathy, you would look for specific clinical manifestations.

The most indicative signs of an anterior dislocation include pain and tenderness in the front of the shoulder and limited range of motion in external rotation.

This is because most dislocations of the humerus occur in an inferior direction when force is applied to an abducted upper limb.

With an anterior dislocation, there may also be a visible deformity, typically in the front of the shoulder, where the humeral head is dislocated from the glenoid cavity.

Posterior dislocations, although less common, would show different signs such as pain in the back of the shoulder and sometimes a visible deformity in the back of the shoulder.

Therefore, symptoms 1) and 2) from the options provided (pain and tenderness in the front of the shoulder and limited range of motion in external rotation) are more suggestive of an anterior shoulder dislocation.