King Fahd Hospital

King Fahd Hospital -Madina Munawrah-Orthopedic Surgery Department

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Post Shoulder Dislocation

Axillary Artery Pseudoaneurysm

can we call this as lateral dislocation of shoulder?
i think , x ray shows soft tissue shadow in the axillary
region pushing the humerus laterally
probably soft tissue sarcoma? or other malignant soft tissue lesion

Suresh
Chennai

Could be villonodular synovitis.

George Thomas,
Chief Orthopaedic Surgeon,
St. Isabel's Hospital,
Mylapore,Chennai 600004,
India.
Phone +91-44-24991081/82/83
Editor, Indian Journal of Medical Ethics,
www.issuesinmedicalethics.org
www.ijme.in

its a carries sicca.tubercular arthritis,or rapidly growing malignent tumor,what is ESR,CRP

thanks

the history is not clear

we needs more information

did you do aspiration or needle biopsy

what about blood test

thanks

B kornah

I think it is synovial sarcoma

hi this is pigmented villonodular synovitis thanks

Assalam o alaikum,

Very interesting x-rays. Cold abscess due to tuberculosis comes in mind. Lets hope, it is not something Malignant i,e Liposarcoma

Khurshid UK

These r inadequate data they may only exclude septic arthritis

hazem

Dr. Muhammad Hamed Mahmoud
Consultant of Orthopedic Surgery,
Millitary Hospitals and Millitary Academy,
Member of the Royal Collage, London UK.

Caseating like material
granulomatous lesion (sarcoidosis)
Inspisated huge pus
non hodjken lymphoma

Thanks ...... for that case. before i give some DD i say to every member Eid Saeed Eid ElFittr. this case may be haemophilic arthritis, chronic infection eg TB or huge haematoma collection or any of soft tissue masses or others . Plz let me know what's the diagnosis

Md AbdelNaby

Dear Dr.......

It may be a blood coagulation factor abnormality, Gout <increase Uric acid>, Rheu.Arthritis,

Beside the MRI I would suggest to do a complete blood test, Aspiration of the fluid for analysis and maybe bone scan

Thanks

B.Fleega MD

dear Dr. ......
we are eagerly waiting for MRI report.

suresh

please give us more details about the swelling , is it firm , hard,cystic what's the size of the swelling clinically send us clinical photos. I beleive it will be appropriate to make MRI.

Bleeding profile of the pt?? I beleive it is either haemoarthrosis or septic shoulder ( intrarticular lesion caz of widening of the jointr space)

thankx

dear dr .......

this is defnitely an intra articular pathology, i dont believe an elbow effussion can reach this amount inthis short time

u have to excluse a synovial pathology, ???synovioma, PVNS?,, dont know i am just thinking,

Mahmoud A. Mahran.

This should be non truamatic origin. Most propably soft tissue tumour.

YASSER ELBATRAWY, MD

LECTURER OF ORTHOPEDIC SURGERY, AZHAR UNIVERSITY.
AOAA MEMBER,
ASAMI INTERNATIONAL MEMBER,
ASAMI NORTH AMERICA MEMBER,

SICOT MEMBER,
EOA MEMBER,

WEB SITE: www.elbatrawy.com

Mobile phone: +20101435969

assalamo alykom

Dr.........

it is really interresting case

apparantly there is separation bet the humeral head and the glenoid

there is soft tissue density

there is interestintingly abnormal density of the humeral head that looklike AVN changes

ther might be small fragment at the greater tuberosity.

there is high possibility fracture line at the articular surface..

the pt need to have CT and MR.

the DDx of the Plain X ray is that intraarticular hematoma in a pt that have abnormal blood HB or clotting factors..

hemarthrosis should be excluded..

if there is no h/o trauma with the loss of fracture line i will consoder tumor or low grade infection..

i will be more than happy if u update me about the case..

thanks

Khalid A. Al-Ismail,MD

Musculoskeletal Radiologist.

Consultant Radiologist.

KFSH&RC (King faisal specialist hospital).

mobile +966505842332

P O Box 85232 Riyadh 11691. Saudi Arabia

Dear Dr .....,

Of course the case is not fully investigated, it needs MRI for better deleneation of the pathological status of surrounding tissues.

Of course DD includes;

1- Heamarthrosis

2- Soft tissue sarcoma

3- Myositis ossificans

4- Scapular chondrosarcoma

etc, but please help us with further investigations,

Thanks,

Best regards

Dr. Mohammed M Kotb, MD Ortho
Lecturer Orthopedics, Assiut University Hospital,
Egypt
Currently, director of Reconstructive Microsurgery
Unit, Saudi German Hospital, Jeddah, Saudi Arabia
PO box; 2550, Jeddah 21461
Tel. 00966-2 6829000/6394000
Fax. 00966-2 6835874/6905038
Mob. 00966-558543389

e.mail, mkotborth@yahoo.com,

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