This case series by Walch et al. describes 13 young men (mean age 40) presenting with glenohumeral arthritis, pain, stiffness, and locking — all with negative instability testing — in whom CT revealed a consistent pattern of static posterior humeral head subluxation occurring without posterior glenoid erosion, defining a previously unrecognized entity distinct from classic primary arthritis.
When a young adult presents with shoulder pain, stiffness, and a sense of instability but negative apprehension and load-and-shift tests, do not stop at plain films — obtain a glenoid profile view and CT to measure glenoid retroversion and the glenohumeral subluxation index, because static posterior subluxation driving early arthritis will be invisible on standard exam.
Recognizing this entity early matters because once cartilage loss is established, no surgical correction attempted to date has reliably halted progression.
This case series by Walch et al. describes 13 young men (mean age 40) presenting with glenohumeral arthritis, pain, stiffness, and locking — all with negative instability testing — in whom CT revealed a consistent pattern of static posterior humeral head subluxation occurring without posterior glenoid erosion, defining a previously unrecognized entity distinct from classic primary arthritis.
When a young adult presents with shoulder pain, stiffness, and a sense of instability but negative apprehension and load-and-shift tests, do not stop at plain films — obtain a glenoid profile view and CT to measure glenoid retroversion and the glenohumeral subluxation index, because static posterior subluxation driving early arthritis will be invisible on standard exam.
Recognizing this entity early matters because once cartilage loss is established, no surgical correction attempted to date has reliably halted progression.