Pseudodislocation of the Shoulder After a Pathologic Scapula Fracture: A Rare Case Report

Shoulder pseudodislocation is a rare clinical entity characterized by radiographic malposition of the humeral head relative to the glenoid despite preserved joint articulation. We present the case of a 79-year-old female with a complex oncologic history involving the scapula who presented to the emergency department with acute shoulder pain. Initial radiographs suggested a glenohumeral dislocation; however, given the patient's complex oncologic history, a closed reduction was deferred in favor of advanced imaging. Subsequent computed tomography (CT) definitively identified the presentation as a pseudodislocation revealing preserved joint articulation despite significant osseous erosion and a pathological fracture of the glenoid and scapular body. Measurement of the glenoid version using the Friedman technique demonstrated a marked deviation of +28.3° anteversion. The patient was managed conservatively with analgesic therapy and immobilization in a neutral position. This case highlights the clinical importance of distinguishing radiographic malposition from true dislocation to avoid unnecessary and potentially harmful procedural interventions, particularly in patients with complex structural bone pathology.