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A 14-year-old athletic girl with a history of intermittent aches and pains following sports presented with right shoulder pain after a fall during basketball. On examination, tenderness over the anterolateral deltoid to the mid-humeral shaft was noted, extremes of shoulder movement were limited, but no deformity was present. No other injuries were present. A right shoulder X-ray was requested (figure 1).
1. What abnormalities are visible on the shoulder X-ray?
2. What is the most likely diagnosis?
Fracture of the surgical neck of the humerus.
Subluxation of the shoulder.
Severe vitamin D deficiency.
3. What investigation is most likely to reveal the underlying diagnosis?
Y-scapula view of the right shoulder.
Serum bone profile.
Radioisotope bone scan.
MRI of the right shoulder.
Skeletal survey, including full spine X-ray.
Serum 25-hydroxyvitamin D …
Contributors JXS prepared the manuscript. FY critically reviewed and edited the manuscript.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.