Paediatric shoulder injury: don’t get sucked in!

Clinical introductionA healthy 8-year-old boy presented to the ED with acute left shoulder pain. He had been playing football and his left arm was pulled by an opposition team member. He fell to the ground and landed on his left shoulder causing pain. On examination after analgesia, active and passive movement of the shoulder joint was possible in all directions but range of motion was limited by pain. There was no visible swelling or bruising throughout the shoulder girdle. A radiograph of the shoulder was obtained (figure 1).Figure 1Plain radiograph of the left shoulder.QuestionWhat radiographic finding is seen for this patient?Glenohumeral lipohaemarthrosis.Acromioclavicular joint disruption.Intra-articular gas.Intra-articular loose body.