CASE 549 Published on 24.10.2000

Lateral scapular displacement in a blunt traumatic scapulo-thoracic dissociation

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Schnyder

Patient

24 years, male

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Clinical History

Motorcycle accident with a close forequarter amputation

Imaging Findings

24-year-old male patient involved in a high-speed deceleration motorcycle accident

Discussion

Scapulo-thoracic dissociation is an uncommon condition encountered in high-energy trauma and most often relate to motorcycle accidents. They occur as a result of a severe abduction of the upper limb, which induces a lateral displacement of the scapula, a massive disruption of the rotator muscular cuff and an extensive subscapular hematoma. Associated neuro-vascular damage is present in 90% of cases.

Differential Diagnosis List

Blunt traumatic scapulo-thoracic dissociation with lateral scapular displacement

Final Diagnosis

Blunt traumatic scapulo-thoracic dissociation with lateral scapular displacement

References

[1] Clements RH, Reisser JR.
Scapulothoracic dissociation: a devastating injury.
J Trauma. 1996 Jan;40(1):146-9. (PMID: 8576982)

[2] Damschen DD, Cogbill TH, Siegel MJ.
Scapulothoracic dissociation caused by blunt trauma.
J Trauma. 1997 Mar;42(3):537-40. (PMID: 9095124)

[3] Sheafor DH, Mirvis SE
Scapulothoracic dissociation: report of five cases and review of the literature.
Emerg Radiol 2: 279-284 (1995).

[4] Wintermark M, Schnyder P
Trauma of the chest wall. In Schnyder P, Wintermark M. Radiology of blunt trauma of the chest. Springer, Berlin Heidelberg New York, pp 9-27 (2000).

Case information

URL:	https://eurorad.org/case/549
DOI:	10.1594/EURORAD/CASE.549
ISSN:	1563-4086

Figure 1

Blunt traumatic scapulo-thoracic dissociation with lateral scapular displacement

Striking lateral displacement of the left scapula as part of a scapulo-thoracic dissociation in a motorcycle driver (From Wintermark M, Schnyder P (2000) Trauma of the chest wall. In Schnyder P, Wintermark M. Radiology of blunt trauma of the chest. Springer, Berlin Heidelberg New York, pp 9-27)