Intended for healthcare professionals

Endgames Case Review

A painful shoulder after a fall

BMJ 2019; 366 doi: (Published 10 September 2019) Cite this as: BMJ 2019;366:l2155
  1. Sarah Abbott, core surgical trainee1,
  2. Sukhmeet Grewal, trauma and orthopaedics SHO2,
  3. Hassan Mehdi, consultant, trauma and orthopaedics2,
  4. Michael Rafferty, , specialist registrar, trauma and orthopaedics3
  1. 1West Middlesex University Hospital, London, UK
  2. 2Northwest London NHS Trust, London, UK
  3. 3The Hillingdon Hospitals NHS Trust, London, UK
  1. Correspondence to S Abbott sarah.abbott9{at}

A 9 year old boy, right hand dominant, presented to the emergency department after falling onto an outstretched hand while jumping over a vaulting box during a physical education lesson. He had no notable medical or surgical history. He complained of pain over his upper arm.

Deformity, tenderness, and swelling were obvious at the level of the upper third of the right humerus. Range of motion at the shoulder was limited due to pain. There was no tenderness over the right clavicle or scapula and no other bony injury in the …

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