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HOW TO ASSESS HUMERAL SUBLUXATION OF THE HUMERUS SHOULDER GLENOHUMERAL JOINT

Mostly we assess humeral subluxation by subjectively assessing the position of the humeral head.
But there is a more reproducible way to do it.
The Scapulohumeral arch which is also called the Gothic Arch or Moloney’s line.

WHAT'S NORMAL & WHAT IS THE SCAPULOHUMERAL ARCH

Normally the inferior margin of the scapula and the medial humerus form a smooth curve.
This smooth curve is called the Scapulohumeral arch. It refers to the relationship of the inferior margin of the scapula and humerus.
If this arch is not disrupted, there is no subluxation.

Image Above: Normal smooth line formed by inferior scapular margin and medial humerus indicates no inferior humeral subluxation.

WHAT'S ABNORMAL

If there is disruption to this curve, its a marker of subluxation of the humeral head.
This disruption can also be seen in posterior dislocations.

WHAT TO LOOK FOR INFERIOR HUMERAL SUBLUXATION AT THE GLENO HUMERAL JOINT

The line formed by the humerus will lie inferior to the line formed by the scapula.

Image Above: Break in the arch formed by the humerus and scapula. Bone fragments under blue line from a Bony Bankart lesion.

WHAT TO LOOK FOR SUPERIOR HUMERAL SUBLUXATION AT THE GLENO HUMERAL JOINT

The line formed by the humerus will lie superior to the line formed by the scapula.

Image Above: Break in the arch formed by the humerus and scapula with superior subluxation of the humerus.

Learn more about this condition & How best to report it in more detail in our SHOULDER MRI Mini Fellowships.

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