History of Present Illness

A 22-year-old man presents to the emergency department (ED) for evaluation of right shoulder pain and concern for a dislocation after rolling over in bed and hearing a crack. The patient notes that the shoulder has gone out in the past but it always pops back in so he has never had it evaluated before. This time the dislocation “appears to have stuck.” The patient denies any other complaints and his left shoulder is normal.

Vital Signs and Physical Examination

The patient’s vital signs are normal.  Physical examination is normal except for guarding of the right shoulder. The relevant testing would be radiographs of the right shoulder (Figures 1 and 2).  

Figure 1. Radiograph of the right shoulder revealing the light-bulb sign.
Figure 2. Scapular view of the injured right shoulder.

Can you diagnose this condition?

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