![](https://i1.wp.com/radrounds.com/wp-content/uploads/2022/06/Inverse_HillSachsLaesion__posterior_shoulder_dislocation__CT_axial_und_Roe_001.jpeg?resize=696%2C381&ssl=1)
Key Points:
- Posterior shoulder dislocations (PSD) are most likely associated with reverse Hill-Sachs lesion is a rare injury, often missed or misdiagnosed
- CT and MRI scans are needed to detect the associated bone and soft tissue lesions usually
- There is radiographic absence of external rotation on images in a standard shoulder series, presence of a lightbulb sign making head look round, trough line sign which is a dense vertical line in the medial humeral head, loss of normal half-moon overlap sign where glenoid fossa appears vacant, and rim sign which is a widened glenohumeral joint
- Reverse Hill-Sachs defect and a reverse Bankart lesion are also commonly seen
Credit: Case contributed by Matt Corey MD to radRounds Radiology Network