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July 27, 1984

Traumatic Disorders of the Shoulder

Author Affiliations

From the Departments of Radiology, The University of Texas Health Science Center at San Antonio (Dr Cone) and the University of California-San Diego and Veterans Administration Medical Center, San Diego (Dr Resnick).

JAMA. 1984;252(4):540-543. doi:10.1001/jama.1984.03350040070031

TRAUMATIC derangements of the glenohumeral joint are commonly encountered in clinical practice. These abnormalities may be acute or chronic and involve the bony supporting structures, cartilaginous elements, and/or periarticular soft tissues of the shoulder. The clinical presentation is usually nonspecific, and appropriate radiological techniques may be diagnostic.

Radiological Evaluation  In most instances, a radiological examination consisting of two or three projections of the glenohumeral joint is adequate. Anteroposterior roentgenograms, obtained with the arm in internal and external rotation, constitute the basic study. In external rotation, the humeral head has a club shape, with the greater tuberosity forming a smooth protuberance along its lateral aspect (Fig 1, left). In internal rotation, the humeral head assumes a symmetrical shape resembling a light bulb, with the greater tuberosity observed en face and the lesser tuberosity forming the medial border (Fig 1, right). These projections do not constitute an ideal examination since the glenohumeral