Have you ever been working a shift at 3 am and wondered, “Am I missing something? I’ll just splint and instruct the patient to follow up with their primary doctor in 1 week.” This is a reasonable approach, especially if you’re concerned there could be a fracture. But we can do better. Enter the “Can’t Miss” series: a series organized by body part that will help identify injuries that ideally should not be missed. This list is not meant to be a comprehensive review of each body part, but rather aims to highlight and improve your sensitivity for these potentially catastrophic injuries. Now: the shoulder
The Shoulder
- Third most common musculoskeletal complaint, only to low back pain and neck pain [1].
- Most commonly dislocated major joint [2].
References
- Bonz, J et al. Emergency Department Evaluation and Treatment of the Shoulder and Humerus. Emerg Med Clin N Am. Vol 33. No 2. May 2015. PMID 25892724
- Rudzinski, J. et al. Chapter 268. Shoulder and Humerus Injuries. In: Tintinalli’s Emergency Medicine. A Comprehensive Guide, 7th edition. New York: McGraw-Hill Education, 2011. P1830-1841
- Warth, R. Acromioclavicular Joint Separations. Curr Rev Musculoskelet Med.2013 Mar; 6(1): 71–78. PMC 3702768
- Longo, U. et al. Missed Fractures of the greater tuberosity. BMC Musculoskeletal Disorders. Volume 19. Issue 1. Aug 2018. PMID 30170571
- Pritchett, J. Inferior sublaxation of the humeral head after trauma or surgery. J shoulder elbow surg. Volume 4. July-August 1997. PMID 9285875