**Question:** What is the finding seen on X-ray of the right shoulder

A. Bilateral acromioclavicular joint dislocation
B. Proximal humerus fracture
C. Glenohumeral dislocation
D. Rotator cuff tear

**Core Concept:**
The shoulder is a complex joint that involves three bones: the humerus, scapula, and clavicle. It is a ball-and-socket joint, allowing for a wide range of motion. X-ray examination is a crucial tool in diagnosing various pathologies affecting the shoulder.

**Why the Correct Answer is Right:**
The correct answer is "B. Proximal humerus fracture" because a fracture occurs when a significant force causes the bone to break. In this case, the force would be exerted on the humerus, leading to a fracture at its proximal end (closer to the body). This type of fracture is specific to the shoulder joint, and the other options are not.

**Why Each Wrong Option is Incorrect:**
A. Bilateral acromioclavicular joint dislocation: Acromioclavicular joint dislocations (AC joint) occur between the acromion process and the clavicle, not the humerus.
C. Glenohumeral dislocation: A dislocation refers to a separation of the ball-and-socket joint, which is the glenohumeral joint. This option is incorrect because it does not represent a fracture.
D. Rotator cuff tear: A rotator cuff tear is an injury to the muscles and tendons surrounding the shoulder joint, not a fracture.

**Clinical Pearl:**
Understanding the various shoulder pathologies on X-ray is crucial for accurate diagnosis and treatment. Fractures are often difficult to diagnose on plain X-ray due to their subtlety, and additional imaging modalities may be required. A thorough physical examination and clinical context are essential in making an accurate diagnosis.