A 65-year-old female presents with severe pain in her left shoulder after a fall. The shoulder appears squared off, and she is unable to actively abduct her arm. What is the likely diagnosis and what are the next steps?
This presentation suggests an inferior shoulder dislocation, also known as a luxatio erecta, which is a rare form of shoulder dislocation. It is characterized by the arm being locked in an abducted position. Initial management includes pain relief, and an X-ray should be obtained to confirm the diagnosis and identify any associated fractures. Once confirmed, the shoulder should be reduced as soon as possible, under sedation or anesthesia.