*36-year-old male with shoulder injury from a motorcycle crash.
What is the most likely diagnosis?
Answer
Answer: Anterior shoulder dislocation and lipohaemarthrosis
Case Discussion:
CT images of the right shoulder revealed anterior shoulder dislocation with displaced fracture of the greater tuberosity and lipohemarthrosis.
Anterior shoulder dislocation is by far the commonest type of dislocation and usually results from forced abduction, external rotation and extension. Lipohaemarthrosis results from an intra-articular fracture with escape of fat and blood from the bone marrow into the joint. It is most frequently seen in the knee, associated with a tibial plateau fracture or distal femoral fracture; rarely a patellar fracture. They have also been described in hip, shoulder, and elbow fractures.
References:
1. Manaster BJ, Disler DG, May DA et-al. Musculoskeletal imaging, the requisites. Mosby Inc. (2002) ISBN:0323011896.
2. Lee JH, Weissman BN, Nikpoor N et-al. Lipohemarthrosis of the knee: a review of recent experiences. Radiology. 1989;173 (1): 189-91.
3. Costa DN, Cavalcanti CF, Sernik RA. Sonographic and CT findings in lipohemarthrosis. AJR Am J Roentgenol. 2007;188 (4): W389.