Pitfall of stiff shoulder: inveterated posterior dislocation

Area of Science:

• Orthopedics
• Neurology
• Emergency Medicine

Background:

• Posterior shoulder dislocation is a rare injury, often missed due to atypical presentation.
• Generalized epileptic attacks can precipitate unusual musculoskeletal injuries.
• Differentiating from other shoulder pathologies requires careful clinical and radiological evaluation.

Observation:

• A case of inveterated bilateral posterior shoulder dislocation is presented.
• The dislocation occurred during a generalized epileptic attack, mimicking a stiff shoulder.
• Key clinical signs included forced internal rotation and restricted external rotation.

Findings:

• Diagnostic challenges in posterior shoulder dislocation are highlighted.
• The necessity of specific radiological views, particularly profile X-rays, is emphasized.
• Computerized tomography (CT) is valuable for pre-operative assessment.

Implications:

• Increased awareness of posterior shoulder dislocation as a complication of epileptic seizures.
• Importance of considering specific clinical and radiological assessments for accurate diagnosis.
• CT scans can aid in surgical planning for complex shoulder dislocations.