Ginger is a 13-year-old who presents three hours after injuring her left shoulder in a fall while ice skating.

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<p>Ginger is a 13-year-old who presents three hours after injuring her left shoulder in a fall while ice skating.</p><p>She is unable to move her shoulder. There is marked subcutaneous bruising and skin puckering at the anterior aspect of the shoulder (pictured).</p><p>On examination there is shoulder joint tenderness, significantly limited shoulder movement and weakness in forearm flexion.</p><p>The distal pulses are normal, and there is no ‘badge area’ or distal sensory deficits.</p><p>There is no emptiness in the shoulder socket on palpation.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.