Ultrasound capsules
Glenohumeral dislocation at the EDU
Why is this view useful?
· Confirm a GH dislocation at the first meeting with a patient if there is any doubt on physical examination.
· Confirm reduction of a GH dislocation while the patient is still sedated.
· Look for intra-articular GH effusion.
· Guide a GH intra-articular puncture or infiltration.
How to get the view?
- Palpate the spine of the scapula up to its lateral terminal part and place the curvilinear probe transversely there.
- Afterwards, adjust the image with small movements to center the GH joint on the screen.
- Positioning: This view CAN BE PERFORMED with a patient asleep, without tone, lying on their back! Indeed, being very lateral (more than people generally believe) it is possible to slip the probe just enough behind the shoulder to verify a successful reduction.
What are we looking for?
- For a dislocation: the absence of the humeral head within the glenoid cavity. If the dislocation is anterior, the humeral head will be in the far field of the screen. If the dislocation is posterior, the humeral head will be in the near field.
- For an effusion: accumulation of fluid (generally anechoic, but which can be heterogeneous when complex/hemorrhagic) at the transition site between the glenoid and the humeral head.
Pitfalls
- The biggest pitfall here is trying to use the linear probe. However, the linear probe offers us better definition, so why not use it...?
The huge advantage of the curvilinear probe is its wide field of view. It allows you to quickly identify structures and reach the conclusions you are looking for . The small footprint of the linear probe often makes it difficult to recognize structures and orient yourself to adjust the image. It is not forbidden to switch to the linear probe after the first identification with the curvilinear if you think that better resolution will help you reach your conclusions (especially for effusion issues).
Anatomie normale
Example of pathologies:
