Glenohumeral malalignment in the hemiplegic shoulder. An early radiologic sign.

A new radiologic sign is described which seems to diagnose an early presubluxation phase of glenohumeral malalignment in hemiplegic shoulders. The sign consists of a V-shaped widening of the upper part of the space between the humeral head and the glenoid cavity on anteroposterior shoulder films in the erect position. Twelve of 14 patients showing this sign went on to develop chronically painful shoulders, and four of them developed radiologically evident subluxation within several months. The sign may be helpful in diagnosing shoulder pathology following stroke at an early stage, when orthotic measures may still have preventive value.