CASE 549 Published on 24.10.2000

Teaching Case

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Schnyder

Patient

24 years, male

View full case Show related cases Notify admin

Clinical History

Motorcycle accident with a close forequarter amputation

Differential Diagnosis List

Blunt traumatic scapulo-thoracic dissociation with lateral scapular displacement

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.

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