A 50 year old patient presented with shoulder pain, stiffness, and a clunking sensation when the arm was raised.
We obtained our standard AP view
and the 'truth' axillary view, showing biconcavity and posterior decentering of the humeral head on the glenoid.
An outside CT scan came with the patient, but did not add information that was not apparent from the plain films.
A total shoulder was performed using an anteriorly eccentric humeral head and a rotator interval plication to manage intraoperative posterior decentering.
A postoperative 'truth' view shows the humeral head centered in the glenoid.
The patient was discharged with over 150 degrees of assisted elevation and no suggestion of posterior instability.
Comment: Preoperative CT scans were not necessary to understand the pathology and special glenoid components were not necessary to correct the posterior decentering.
See these related posts:Shoulder joint replacement arthroplasty - x-ray evaluation
Managing posterior instability with an anteriorly eccentric humeral head component
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