A painful shoulder after a seizure

• Published in: BMJ (Online) Vol. 366; p. l4511
• Main Authors: Oputa, Tobenna Jerris, Davies, Ronnie
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 08-08-2019
• Subjects: Check lists; Fractures; Humerus; Pain; Patients; Radiography; Seizures; Shoulder; Trauma
• ISSN: 0959-8138; 1756-1833
• DOI: 10.1136/bmj.l4511

The humeral head (H) is seen adjacent to the glenoid (G) and has a more spherical shape than usual due to internal rotation (IR) of the arm Posterior dislocations—where the humeral head (fig 2, H) is displaced posteriorly in relation to the glenoid fossa (G)—account for 3% of shoulder dislocations; they are commonly caused by seizures or high energy trauma.1 Patients experience pain and reduced movement, and are unable to externally rotate the shoulder.2 Radiographs may show a lightbulb sign (fig 2). Simple dislocations can be reduced in the emergency department by providing external rotation with the arm flexed and adducted.1 Refer patients with chronic dislocations or associated fractures for an orthopaedic opinion as open reduction in theatre may be required. [...]details of The BMJ policy on financial interests is here: https://www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists/declaration-competing-interests Provenance and peer review: not commissioned; externally peer reviewed.