The Posterior Unstable Shoulder: Natural History, Clinical Evaluation and Imaging

Jorge Díaz Heredia1, *, Miguel Angel Ruiz Iban1, Raquel Ruiz Diaz1, Santos Moros Marco2, Juan Carlos Gutierrez Hernandez1, Maria Valencia3
1 Unidad de Hombro y Codo. Servicio de Traumatología y Cirugía Ortopédica. Hospital Universitario Ramón y Cajal, Madrid, Spain
2 Servicio de Traumatología y Cirugía Ortopédica, Clínica MAZ, Zaragoza, Spain
3 Unidad de Hombro y Codo. Servicio de Traumatología y Cirugía Ortopédica. Fundación Jimenez Diaz, Madrid, Spain

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© 2017 Heredia et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Servicio de COT. Hospital Ramón y Cajal, Cta Colmenar Km 9.100. Madrid 28034. SPAIN, Tel: +34913368601 Fax: +34913368474; Email:



There is a low incidence of posterior instability which is present in only 2% to 10% of all unstable shoulders. The posterior instable shoulder includes different manifestations like fixed dislocation, recurrent subluxation or dislocation.


Research and online content related to posterior instability is reviewed. Natural history, clinical evaluation and imaging are described.


An awareness of the disorder, together with a thoughtful evaluation, beginning with the clinical history, usually leads to proper diagnosis. An appropriate physical exam, taking in account hyperlaxity and specific tests for posterior instability should be done.


Posterior shoulder instability is an uncommon condition and is challenging to diagnose. There is not a single injury that is responsible for all cases of recurrent shoulder dislocation or subluxation, and the presence of soft tissue lesions or bone alterations should be evaluated, with the use of adequate simple radiology and multiplanar imaging.

Keywords: Posterior instability, Posterior luxation, Posterior subluxation, Posterior dislocation, Physical exam, Imaging.