Differential Diagnosis for Left Shoulder X-ray Findings
Single Most Likely Diagnosis
- Anterior shoulder dislocation with associated fractures (Hill-Sachs deformity and possible greater tuberosity fracture): This diagnosis is the most likely due to the direct findings of an anterior inferior shoulder dislocation, a Hill-Sachs deformity indicating a compression fracture of the humeral head, and a calcified fragment suggestive of a greater tuberosity fracture.
Other Likely Diagnoses
- Bony Bankart lesion: The subtle irregularity of the anterior inferior glenoid suggests a possible bony Bankart fracture, which is a common injury associated with anterior shoulder dislocations.
- Greater tuberosity fracture: The presence of a calcified fragment adjacent to the greater tuberosity supports this diagnosis as a distinct possibility.
- Soft tissue injuries (e.g., labral tears, rotator cuff injuries): Although not directly visible on the X-ray, these injuries are commonly associated with shoulder dislocations and fractures.
Do Not Miss Diagnoses
- Vascular injury: Although less common, vascular injuries (e.g., axillary artery damage) can occur with severe shoulder trauma and dislocations, making them critical not to miss due to potential severe consequences.
- Neurological injury: Similarly, nerve injuries (e.g., axillary nerve) can occur and must be considered to ensure appropriate management and rehabilitation.
Rare Diagnoses
- Scapular fracture: While the scapula appears normal in the provided images, complex scapular fractures can sometimes be subtle and require additional imaging for diagnosis.
- Clavicle fracture: Although the clavicle is reported as normal, occult fractures can sometimes be missed on initial X-rays, especially if they are nondisplaced or if the X-ray views are limited.
- Osteonecrosis of the humeral head: A potential long-term complication of shoulder dislocation, especially with associated fractures like Hill-Sachs deformity, but not an immediate concern based on the provided X-ray findings.