Skeletal Radiology

, Volume 48, Issue 3, pp 467–473 | Cite as

Sequelae of bilateral luxatio erecta in the acute post-reduction period demonstrated by MRI: a case report and literature review

  • Pei Ing Ngam
  • James Thomas Hallinan
  • David Soon Yiew SiaEmail author
Case Report


Luxatio erecta humeri (LEH), also known as inferior shoulder dislocation, is uncommon, comprising about 0.5% of all cases of shoulder dislocation. Synchronous bilateral LEH is exceedingly rare and, to our knowledge, there are no descriptions of axillary nerve injury on magnetic resonance imaging (MRI) following LEH. We present a case of traumatic bilateral LEH in a 59-year-old woman who fell from a fast-moving mobility scooter and sustained direct axial loading forces on the fully abducted shoulders. Both shoulders were successfully reduced using the traction–countertraction technique in the emergency department. In this article, we describe the characteristic features of LEH on plain radiography and the pattern of acute soft-tissue injuries on MRI. We emphasize the importance of reviewing the axillary neurovascular bundle, which by virtue of its location beneath the shoulder joint, is prone to injury in inferior shoulder dislocation and thus has a substantial impact on functional recovery. This important complication is unfortunately not routinely examined by radiologists, partly because of the paucity of literature highlighting its clinical significance.


Luxatio erecta humeri LEH Inferior shoulder dislocation Axillary nerve Neurapraxia Nerve palsy Magnetic resonance imaging MRI 



The authors declare that they have not received any internal or external funding.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical treatment of human/animal subjects

Not applicable.

Informed consent

Not applicable.


  1. 1.
    Omoumi P, Teixeira P, Lecouvet F, Chung CB. Glenohumeral joint instability. J Magn Reson Imaging. 2011;33(1):2–16.CrossRefGoogle Scholar
  2. 2.
    Hassanzadeh E, Chang CY, Huang AJ, Shaqdan K, Mansouri M, Aran S, et al. CT and MRI manifestations of luxatio erecta humeri and a review of the literature. Clin Imaging. 2015;39(5):876–9.CrossRefGoogle Scholar
  3. 3.
    Nambiar M, Owen D, Moore P, Carr A, Thomas M. Traumatic inferior shoulder dislocation: a review of management and outcome. Eur J Trauma Emerg Surg. 2017;44(1):45–51.CrossRefGoogle Scholar
  4. 4.
    Karaoglu S, Guney A, Ozturk M, Kekec Z. Bilateral luxatio erecta humeri. Arch Orthop Trauma Surg. 2003;123(6):308–10.CrossRefGoogle Scholar
  5. 5.
    Groh GI, Wirth MA, Rockwood CA Jr. Results of treatment of luxatio erecta (inferior shoulder dislocation). J Shoulder Elbow Surg. 2010;19(3):423–6.CrossRefGoogle Scholar
  6. 6.
    Mallon WJ, Bassett FH 3rd, Goldner RD. Luxatio erecta: the inferior glenohumeral dislocation. J Orthop Trauma. 1990;4(1):19–24.CrossRefGoogle Scholar
  7. 7.
    Kumar KS, O’Rourke S, Pillay JG. Hands up: a case of bilateral inferior shoulder dislocation. Emerg Med J. 2001;18(5):404–5.CrossRefGoogle Scholar
  8. 8.
    Stensby JD, Fox MG. MR arthrogram findings of luxatio erecta in a pediatric patient-arthroscopic confirmation and review of the literature. Skeletal Radiol. 2014;43(8):1191–4.CrossRefGoogle Scholar
  9. 9.
    Davids JR, Talbott RD. Luxatio erecta humeri. A case report. Clin Orthop Relat Res. 1990;252:144–9.Google Scholar
  10. 10.
    Downey EF Jr, Curtis DJ, Brower AC. Unusual dislocations of the shoulder. AJR Am J Roentgenol. 1983;140(6):1207–10.CrossRefGoogle Scholar
  11. 11.
    Brady WJ, Knuth CJ, Pirrallo RG. Bilateral inferior glenohumeral dislocation: luxatio erecta, an unusual presentation of a rare disorder. J Emerg Med. 1995;13(1):37–42.CrossRefGoogle Scholar
  12. 12.
    Sogut O, Yigit M, Karayel E, Demir N. Luxatio erecta humeri: hands-up dislocation. J Emerg Med. 2015;49(2):e53–5.CrossRefGoogle Scholar
  13. 13.
    Mohseni MM. Images in emergency medicine. Luxatio erecta (inferior shoulder dislocation). Ann Emerg Med. 2008;52(3):203–31.CrossRefGoogle Scholar
  14. 14.
    Krug DK, Vinson EN, Helms CA. MRI findings associated with luxatio erecta humeri. Skeletal Radiol. 2010;39(1):27–33.CrossRefGoogle Scholar
  15. 15.
    Al-Saadi SK, Olsen BS. Luxatio erecta—a rare type of shoulder dislocation. Ugeskr Laeger. 2009;171(34):2399–400.PubMedGoogle Scholar
  16. 16.
    Linda DD, Harish S, Stewart BG, Finlay K, Parasu N, Rebello RP. Multimodality imaging of peripheral neuropathies of the upper limb and brachial plexus. Radiographics. 2010;30(5):1373–400.CrossRefGoogle Scholar
  17. 17.
    Avis D, Power D. Axillary nerve injury associated with glenohumeral dislocation: a review and algorithm for management. EFORT Open Rev. 2018;3(3):70–7.CrossRefGoogle Scholar
  18. 18.
    Grate I Jr. Luxatio erecta: a rarely seen, but often missed shoulder dislocation. Am J Emerg Med. 2000;18(3):317–21.CrossRefGoogle Scholar
  19. 19.
    Kelley C, Quimby T, MacVane CZ. Unusual shoulder injury from a motorcycle crash. Luxatio erecta. J Fam Pract. 2013;62(5):255–7.PubMedGoogle Scholar
  20. 20.
    Khedr H, Al-Zahrani A, Al-Qattan MM. Bilateral irreducible inferior shoulder dislocation: a case report. Int J Surg Case Rep. 2017;31:124–7.CrossRefGoogle Scholar
  21. 21.
    Frank MA, Laratta JL, Tan V. Irreducible luxatio erecta humeri caused by an aberrant position of the axillary nerve. J Shoulder Elbow Surg. 2012;21(7):e6–9.CrossRefGoogle Scholar

Copyright information

© ISS 2018

Authors and Affiliations

  • Pei Ing Ngam
    • 1
  • James Thomas Hallinan
    • 1
  • David Soon Yiew Sia
    • 1
    Email author
  1. 1.Department of Diagnostic ImagingNational University HospitalSingaporeSingapore

Personalised recommendations