Shoulder and Brachial Plexus Case 1

A 30-year-old rugby player attends the emergency department having been taken off the pitch with a left shoulder injury. He says that in a scrum it was “knocked out of place”.

Observation and examination of the shoulder are normal, except for some pain globally on active movement. There is no sign of rotator cuff injury.

You ask for a plain radiograph (click on the x-ray to enlarge). The AP view is entirely normal and the axial is shown. What does the x-ray show?

The implication of this finding is that the patient has suffered more than one:

An MR arthrogram demonstrates a tear of the antero-inferior aspect of the glenoid labrum which is displaced from its normal position (see arrow).

What management plan would you formulate?