The Veil of Obscuration: Additional Radiographic Sign of Posterior Shoulder Dislocation

Lana Hirai Gimber, Mihra S. Taljanovic, Zachary A. Rockov, Elizabeth A. Krupinski, Tyson S. Chadaz, Lee F. Rogers


Objective. To describe a new radiographic sign, “veil of obscuration”, associated with posterior glenohumeral joint (shoulder) dislocations and determine its incidence and validity compared to other known classic radiographic signs.

Methods. Four-year retrospective study identified 30 acute posterior shoulder dislocation patients. Radiographs reviewed in consensus by 2 musculoskeletal radiologists for the “veil of obscuration”, seen on AP shoulder radiographs and representing a comminuted fracture of the lesser tuberosity projecting over the humeral head or glenohumeral joint. Incidence of this radiographic sign of posterior glenohumeral joint dislocation in addition to other previously described classic radiographic signs, and association with other fractures, surgery, and mechanism of injury were evaluated. Continuous data was analysed with student t-test and categorical data with Chi-Square test.

Results. There were 20 right and 10 left posterior shoulder dislocations. Majority of injuries resulted from vehicle crash (44%). In most cases, reverse Hill-Sachs lesion (83%) and fixed internal rotation of the humeral head (76%) were present, followed by trough line (43%) and “veil of obscuration” (40%). Trough line was seen in significantly more major trauma and vehicle crashes (78% and 46%; P=0.015), while “veil of obscuration” was seen in more seizures (86%; P=0.037) and in all surgical patients.  No significant difference in presence of other classic radiographic signs in regards to surgery.

Conclusion. The newly described radiographic sign of posterior shoulder dislocations named the “veil of obscuration” has comparable incidence as other classic radiographic signs and may be useful in the recognition and diagnosis of these injuries.


Posterior; Shoulder; Glenohumeral; Dislocation; Radiograph

Full Text:




  • There are currently no refbacks.

2019 Department of Medical Sciences, Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina. All rights reserved.
The full text of articles published in this journal can be used free of charge for personal and educational purposes while respecting authors and publishers’ copyrights. For commercial purposes no part of this journal may be reproduced without the written permission of the publisher.