Last reviewed: March 2020
Last updated: May  2018



History and exam

Key diagnostic factors

  • presence of risk factors
  • characteristic posturing of joint
  • pain
  • inability to move joint
  • tenderness
  • swelling
  • normal neurological function of shoulder and elbow
  • sciatic nerve injury with hip dislocation
  • injury to the femoral artery, vein, or nerve with hip dislocation
  • concomitant injury with hip dislocation
  • cruciate ligament injury with patellar dislocation
  • meniscal tears with patellar dislocation
  • ligamentous injuries of the knee with patellar dislocation
  • patellar or quadriceps tendon rupture with patellar dislocation

Other diagnostic factors

  • ecchymosis with finger dislocation
  • haemarthrosis with patellar dislocation

Risk factors

  • sports-related activities
  • motor vehicle accident
  • ligamentous laxity
  • Ehlers-Danlos syndrome
  • males between adolescence and 40 years of age
  • women aged 61 to 80 years
  • prior history of joint instability
  • skeletal or muscular dysplasia
  • high Q angle
  • external tibial torsion
  • patella alta

Diagnostic investigations

1st investigations to order

  • plain x-rays of the shoulder
  • plain x-rays of the finger
  • plain x-rays of the knee
  • plain x-rays of the elbow
  • plain x-rays of the pelvis
More 1st investigations to order

Investigations to consider

  • MRI scan of the knee
  • MRI scan of the shoulder
  • CT scan of the elbow
  • CT scan of the pelvis
  • arteriogram of the knee or shoulder
More investigations to consider

Treatment algorithm


The San Antonio Orthopaedic Group

San Antonio



TMD has been a consultant for Arthrex Inc, Musculoskeletal Transplant Foundation (MTF), and ConMed. He has received research support from Arthrex Inc, Histogenics, and Regentis, and has received fellowship support, patent remuneration, and royalties from Arthrex Inc. TMD is on the Scientific Medical Board of Aesculap Inc.

Dr Thomas M. DeBerardino would like to gratefully acknowledge Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this monograph. PN and BP declare that they have no competing interests.

Peer reviewersVIEW ALL

Co-director of Orthopedic Sports and Shoulder Service

Department of Orthopedic Surgery

Naval Medical Center San Diego

San Diego



DJS declares that he has no competing interests.

Assistant Director

Orthopaedic Shoulder and Sports Surgery

Naval Medical Center San Diego

San Diego



MTP declares that he has no competing interests.

Head of Orthopaedic Surgery

Women's & Children's Hospital


South Australia



PC declares that he has no competing interests.

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