The V-Sign: A Simple Radiographic Sign of Shoulder Subluxation

Introduction Shoulder subluxation is a common finding associated with orthopedic pathology. This study assesses the inter- and intra-observer reliability of a new radiographic sign used to identify glenohumeral subluxation. Methods Shoulders of 55 consecutive patients presenting with shoulder pain were reviewed for the presence of a “V-sign”. Three shoulder surgeons reviewed all radiographs at three separate time periods in a randomized fashion. Inter- and intra-observer reliabilities were calculated. Results The V-sign was identified in 26 (47%) shoulders. Intra-rater reliability was satisfactory for all the three surgeons, with kappa values of 0.85, 0.78, and 0.77, respectively. Inter-rater reliability was similarly satisfactory, with a value of 0.71. The surgeons demonstrated 100% agreement on the direction of subluxation when a V-sign was documented. Discussion The V-sign is a reproducible radiographic sign that can be used to detect glenohumeral subluxation in patients presenting with shoulder pain.