How to Diagnose Anterior Glenohumeral Subluxation

The term "glenoid" refers to a socket and "humeral" means having to do with the upper arm bone, so "glenohumeral" refers to the shoulder socket. A "luxation" is a dislocation, so a subluxation is an incomplete dislocation where the joint surfaces still make contact, although their relationship is altered. An "anterior glenohumeral subluxation" is a forward partial dislocation of the shoulder socket. Here's how to diagnose an anterior glenohumeral subluxation.

Instructions

Difficulty: Challenging

1. Obtain the patient history. An anterior glenohumeral subluxation is almost always a sports-related injury resulting from a vigorous or repeated overhead motion of the arms. It is especially common in baseball pitchers, javelin throwers, swimmers and tennis players.
2. Examine the affected shoulder. The most common onset is shoulder pain when trying to rotate the shoulder. The patient typically experiences a sharp pain and may even lose control of the arm in an episode of pain induced paresis. The shoulder may still be sore at the time of presentation.
3. Take radiographs as the first imaging technique. It is inexpensive, readily available and frequently obviates the need for further imaging.
4. View the radiographs to determine the extent of the subluxation. Radiographs also can be used to eliminate other sources of shoulder pain such as a Hill-Sachs lesion, fractures and degenerative changes in the joint.
5. Perform Magnetic Resonance arthrography as the imaging method of choice to evaluate the labrum. This procedure is invasive, however, and normally done only when surgery is being considered.