SHM Converge Scientific Abstract ePoster Gallery-Bilateral Anterior Shoulder Dislocations: Not Lightning, Still a Shock

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This case report describes a rare cause of bilateral shoulder pain in a 33-year-old previously healthy man who presented with two days of severe bilateral shoulder pain and chest swelling. He was ultimately found to have spontaneous bilateral anterior shoulder dislocations with bilateral displaced humerus fractures, along with acute kidney injury and rhabdomyolysis.<br /><br />The patient denied trauma, strenuous exercise, drug or heavy alcohol use, new medications, seizures, or electrical injury. Initial urgent care imaging was read as normal in the lungs, but repeat evaluation in the emergency department raised concern for bilateral shoulder dislocations. Labs showed markedly elevated creatine kinase, mildly elevated troponin, creatinine above baseline, and urinalysis positive for blood without red blood cells, consistent with rhabdomyolysis. X-rays of both shoulders confirmed the bilateral anterior dislocations and fractures. MRI and EEG were normal, though later exam noted a tongue bite, suggesting a possible unwitnessed seizure.<br /><br />The report emphasizes that bilateral anterior shoulder dislocations are extremely rare. In a review of 70 cases, about 50% were due to trauma, 37% to strong muscle contractions such as seizures or electrocution, and 13% were atraumatic. Nearly half were associated with fractures. The case highlights the importance of personally reviewing imaging, keeping a broad differential diagnosis, and performing a careful physical examination, since early recognition is key to better outcomes.

Asset Subtitle

Sylvia R. Sidky

Meta Tag

Author List Courtney J. Burnett, Sylvia R. Sidky

Category Clinical Vignettes

Concept Bilateral Anterior Shoulder Dislocation

Concept Shoulder Dislocation

Concept Early Diagnosis

Concept Humerus Fracture

Concept Radiologic Findings

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Sylvia R. Sidky

Track Adult

Keywords

bilateral shoulder pain

spontaneous dislocation

anterior shoulder dislocation

humerus fracture

rhabdomyolysis

acute kidney injury

seizure

chest swelling

imaging review

case report

Bilateral Anterior Shoulder Dislocation

Shoulder Dislocation

Early Diagnosis

Humerus Fracture

Radiologic Findings