Pediatric emergency medicine trisk 0868 0868
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FIGURE 43.6 Approach to the patient with an injured shoulder.
If the child seems anxious, examine the uninjured side first. Carefully palpate
the entire shoulder from sternoclavicular joint to the shaft of the humerus.
Swelling and tenderness at the sternoclavicular joint suggests a fracture or
dislocation at this site. The clavicle is covered only by a thin platysma muscle,
and a fracture is easily seen and palpated. Just lateral to the clavicle is the AC
joint. Elevation of the clavicle above the acromion or tenderness of the
articulation suggests AC joint injury or lateral clavicle fracture. Just in front of
the greater tuberosity of the humerus is the tendon of the long head of the biceps
