Dimple on the shoulder after a ski injury.

CLINICAL INTRODUCTION

A 74-year-old woman was brought to the ski clinic shortly after a fall on her left shoulder while skiing. She did not remember the exact fall mechanism. She felt a popping sensation in her left shoulder and was unable to move her left arm due to severe pain. Her medical and social histories were unremarkable. On physical examination, she had a deformity in her left shoulder (figure 1). Her neurovascular examination was intact.emermed;34/11/740/F1F1F1Figure 1Photograph of the left shoulder on arrival showing an anterior 'dimple'.

QUESTION

What is the most likely diagnosis of the injury? An acromioclavicular joint (ACJ) sprain (shoulder separation)A proximal humerus fractureA distal clavicle fractureA posterior glenohumeral dislocation.