Dimple on the shoulder after a ski injury.

CLINICAL INTRODUCTION: A 74-year-old woman was brought to the ski clinic shortly after a fall on her left shoulder while skiing. She did not remember the exact fall mechanism. She felt a popping sensation in her left shoulder and was unable to move her left arm due to severe pain. Her medical and social histories were unremarkable. On physical examination, she had a deformity in her left shoulder (figure 1). Her neurovascular examination was intact.emermed;34/11/740/F1F1F1Figure 1Photograph of the left shoulder on arrival showing an anterior 'dimple'.

QUESTION: What is the most likely diagnosis of the injury? An acromioclavicular joint (ACJ) sprain (shoulder separation)A proximal humerus fractureA distal clavicle fractureA posterior glenohumeral dislocation.