Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem

Bilateral anterior shoulder dislocation is a rare clinical entity with few case reports and limited series published in the literature. Bilateral shoulder dislocations are rare and of them, most are posterior. We present a highly unusual case of bilateral, atraumatic, anterior shoulder dislocation w...

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Bibliographic Details
Published in:BMJ case reports 2016-03, Vol.2016, p.bcr2015214292
Main Authors: Martin, Alexander Nicholas, Tsekes, Dimitris, White, William James, Rossouw, Dan
Format: Article
Language:English
Subjects:
Adult
Braces
Chloroquine - adverse effects
Closed reduction
Consciousness
Convulsions & seizures
Emergency medical care
Epilepsy
Fainting
Fractures, Comminuted - chemically induced
Fractures, Comminuted - therapy
Humans
Male
Seizures - chemically induced
Seizures - complications
Shoulder
Shoulder Dislocation - chemically induced
Shoulder Dislocation - diagnostic imaging
Shoulder Dislocation - therapy
Trauma
Treatment Outcome
United Kingdom
Unusual Association of Diseases/Symptoms
White
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Summary:Bilateral anterior shoulder dislocation is a rare clinical entity with few case reports and limited series published in the literature. Bilateral shoulder dislocations are rare and of them, most are posterior. We present a highly unusual case of bilateral, atraumatic, anterior shoulder dislocation with concomitant comminuted greater tuberosity fracture on the right side, secondary to seizure, in a patient without known epilepsy, induced by oral chloroquine medication. We demonstrate the treatment approach that led to a satisfactory clinical outcome, evidenced by radiological union, clinical assessment and Patient Reported Outcome Measure data, following non-operative management of both shoulders. The unusual mechanism for anterior shoulder dislocation, the asymmetric dislocation pattern and peculiar precipitant for the causative seizure all provide interesting learning points from this case.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2015-214292