A 15-year-old boy presents with a right painful shoulder, after falling while snowboarding two days ago.

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<p>A 15-year-old boy presents with a right painful shoulder, after falling while snowboarding two days ago.</p><p>He fell heavily, sustaining a direct lateral impact to the shoulder.</p><p>He reports anterior shoulder pain and is unable to adduct the arm due to this pain.</p><p>Shoulder range of motion is otherwise normal, but painful throughout.</p><p>There is no obvious deformity. There is tenderness medial to the acromioclavicular joint.</p><p>His X-ray is pictured.</p>

Dr Ash Chehata is an orthopaedic surgeon specialising in upper limb surgery, based in Melbourne, Vic.