Hi All,

I observed this 55 yrs old male fell from a two level double decker bus over ten steps spiralling face foward.

His head and operated shoulder hit the steps and the handle bar and he was sent to ED in neck brace.

He had 2 weeks earlier underwent a Subacromial Decompression (SAD) with intra-operation of supraspinatus (SSP) tear repair.

The ED found during the right shoulder X-Ray, that there is subtle inferior subluxation of the right humeral head which may "suggest a small right shoulder joint effusion".

Except for head and body bumps, bruises and degenerative spine, hips, neck and age-old head involition, his right shoulder is more pronounced with pain.

Nothing was done to the body except given pain-killers and for the shoulder, the orthopedic surgeon sent his MO not to assess the pain but to STO only with no further instruction but to return in 6 months time for "pain assessment".

Question -

1) What is the likeable treatment given such scenario?

2) Is another shoulder repair required to normalise the ailing shoulder?

3) Else, what is the "gold standard" for the "small" right shoulder joint effusion treatment.

Appreciate any feedback - Thanks - Mariam