A 72 year old man is brought to the emergency department following a fall in the street. He is a sprightly chap and was on the way to the shops when he tried to jump a kerb and slipped on some wet leaves. He landed on his right arm and is complaining of a great deal of pain in his right shoulder.

You place a broad arm sling and give him some oral analgesia which significantly helps.

Clinical examination reveals a swollen painful shoulder that is restricted in movement as a result of pain.

You are pretty confident that he has had a mechanical fall.

You send him for an X-ray.

See his X-ray here