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Published on: July 5, 2011

Spontaneous haemarthrosis causing anterior shoulder dislocation.

Lena Wirth¹, Paul Cornelius

¹Department of Paediatrics, Queen's Hospital, Rom Valley Way, Romford, UK. lena.wirth@doctors.org.uk

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine

|November 3, 2009

Summary

Spontaneous shoulder bleeding, or haemarthrosis, can mimic anterior dislocation in patients on anticoagulant therapy. Prompt joint aspiration and physiotherapy are key for recovery, highlighting the need for careful diagnosis in at-risk individuals.

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Area of Science:

Orthopedics
Hematology
Emergency Medicine

Background:

Nontraumatic haemarthrosis is a known complication of anticoagulant therapy.
Typically affects large, weight-bearing joints like the knee.
Anticoagulant therapy is frequently prescribed for conditions such as pulmonary embolism.

Observation:

A 53-year-old female on anticoagulants presented with acute, severe shoulder pain and no history of trauma.
Radiological examination revealed an apparent anterior shoulder dislocation.
Initial attempts at closed reduction under sedation were unsuccessful.

Findings:

The patient underwent shoulder joint aspiration.
The apparent dislocation was caused solely by spontaneous haemarthrosis.
Full recovery was achieved following physiotherapy.

Implications:

Spontaneous haemarthrosis should be considered in patients on anticoagulants presenting with apparent atraumatic shoulder dislocation.
This diagnosis is crucial, especially when the joint is not typically affected, like the shoulder.
Early recognition and appropriate management can prevent complications and ensure patient recovery.