What causes drooping shoulder sign in the shoulder on radiography?
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Answer:
The drooping shoulder sign is caused by inferior subluxation of the humeral head relative to the glenoid fossa, most commonly due to hemarthrosis or musculoligamentous injury following a fracture of the surgical neck of the humerus. It may also be associated with septic arthritis, hemarthrosis secondary to coagulopathy, or other conditions leading to joint effusion or instability.
Why is it called so?:
It is called the drooping shoulder sign because the affected shoulder appears to “droop” or sag inferiorly on imaging, reflecting the downward displacement of the humeral head.
Pathophysiology:
The sign develops when trauma or pathology disrupts the integrity of the shoulder joint, leading to accumulation of blood or fluid (hemarthrosis) or injury to supporting ligaments and muscles. This results in loss of normal support for the humeral head, causing it to sublux inferiorly and creating a widened space between the clavicle and humeral head on radiographs.
Alternative names:
Drooping shoulder syndrome, inferior humeral subluxation, “drooping shoulder” sign
Other associated named signs:
None directly associated
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