The Shoulder

Fracture prevalence | Projections | Normal paediatric anatomy
Proximal humerus | Clavicle | Scapula | Glenoid
Anterior dislocation | Posterior dislocation | Acromioclavicular joint subluxation | Pseudo-subluxation
Rotator cuff arthropathy | Bone metastases | Simple bone cyst

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Learning outcomes
  • Assess skeletal radiographs using a systematic approach
  • Understand the different radiographic projections and how the anatomy changes with position
  • Understand what injuries will be demonstrated on different projections
  • Describe shoulder girdle anatomy
  • Understand mechanisms of injury and the likely fractures/dislocations which may result
  • Recognise less common fractures to the individual bones of the shoulder girdle
  • Accurately describe glenohumeral dislocations and associated fractures
  • Understand common eponyms
  • Recognise potential ligament injuries
  • Identify normal paediatric anatomy and the development of secondary ossification centres
  • Recognise common pathological conditions seen around the shoulder girdle
Fracture prevalence
Under 10 years
Fractured clavicle
15-40 years
Acromioclavicular joint subluxation
Glenohumeral joint dislocation
Under 20 years and over 60 years
Fractured proximal humerus

Axial   Modified axial   Y view
Normal paediatric anatomy
Normal paediatric shoulder Normal paediatric shoulder Normal paediatric shoulder Normal paediatric shoulder
12 years
14 years
15 years
17 years
Normal paediatric axial   Normal paediatric axial
Proximal humeral fractures
Greater tuberosity, surgical neck fractures

Metaphyseal fracture
   Metaphyseal fracture
Clavicle, ribs, scapular fractures   Clavicle, ribs, scapular fractures
Clavicle fractures
Fractured clavicle, normal ossification centres
Scapula fractures
Fracture scapula blade
Glenoid fractures
Glenoid fracture
Anterior glenohumeral dislocation
Anterior dislocation
Anterior dislocation, Hill-Sachs defect   Anterior dislocation, Hill-Sachs defect
Anterior dislocation, Bankart lesion   Anterior dislocation, Bankart lesion   Post-reduction, Bankart lesion
Anterior dislocation, fracture greater tuberosity   Anterior dislocation, fracture greater tuberosity
Posterior glenohumeral dislocation
Posterior dislocation
Acromioclavicular joint subluxation
Wide ACJ   Subluxed ACJ   Dislocated ACJ
Pseudosubluxation, fracture surgical neck
Rotator cuff arthropathy
Rotator cuff tendonopathy
Bone metastases
Bony metastases
Simple/Solitary/Unicameral bone cyst
Solitary bone cyst

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