Unrecognized Posterior Shoulder Dislocation in a Recreational Cyclist: A Case Report

Abstract

Background Posterior shoulder dislocation (PSD) is commonly associated with a history of strong excessive muscle contraction (generalized seizures, electric shock) and may result from high-energy injuries such as a motor vehicle accident. Case Presentation A 58-year-old recreational cyclist reported night pain and functional limitations in his left shoulder, due to a trauma occurring 7 months earlier. The patient’s history and clinical examination led the physical therapist to suspect PSD. Therefore, the patient was referred to a surgeon for advanced imaging, which confirmed PSD as well as an associated McLaughlin lesion and rotator cuff tear. Outcome and Follow-Up Reverse total shoulder arthroplasty was performed, followed by a 12-week rehabilitation program. Muscle strength assessment, the Shoulder Disability Questionnaire, and the Medical Outcomes Study 36-Item Short-Form Health Survey were used to assess outcomes. Discussion The diagnosis of PSD with an associated McLaughlin lesion is often delayed. This case report highlights the importance of a thorough clinical assessment, which is mandatory to identify pathologies requiring multidisciplinary management. JOSPT Cases 2021;1(3):150–158. doi:10.2519/josptcases.2021.10388