Joint dislocation
小结
定义
病史和体格检查
关键诊断因素
- presence of risk factors
- characteristic posturing of joint
- pain
- inability to move joint
- tenderness
- swelling
- 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
其他诊断因素
- ecchymosis with finger dislocation
- haemarthrosis with patellar dislocation
危险因素
- sports-related activities
- motor vehicle accident (hip dislocation)
- ligamentous laxity
- Ehlers-Danlos syndrome
- males between adolescence and 30 years of age
- women aged 61-80 years (shoulder dislocation)
- prior history of joint instability
- skeletal or muscular dysplasia
- high Q angle (patellar dislocation)
- external tibial torsion (patellar dislocation)
- patella alta (patellar dislocation)
诊断性检查
首要检查
- 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
需考虑的检查
- MRI scan of the knee
- MRI scan of the shoulder
- CT scan of the elbow
- CT scan of the pelvis
- MRI scan of the pelvis
- arteriogram of the knee or shoulder
新兴检查
- ultrasound of the shoulder
治疗流程
shoulder dislocation
finger dislocation
patellar dislocation
elbow dislocation
hip dislocation
撰稿人
作者
Thomas M. DeBerardino, MD
Division Chief, Sports Medicine
Department of Orthopaedic Surgery
UT Health San Antonio
San Antonio
TX
利益声明
TMD is a paid consultant and receives royalties from Arthrex, Inc. He has contributed to educational events for Arthrex, Inc.
鸣谢
Dr Thomas M. DeBerardino would like to gratefully acknowledge Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this topic.
利益声明
PN and BP declare that they have no competing interests.
同行评议者
Daniel J. Solomon, MD
Co-director of Orthopedic Sports and Shoulder Service
Department of Orthopedic Surgery
Naval Medical Center San Diego
San Diego
CA
利益声明
DJS declares that he has no competing interests.
Matthew T. Provencher, MD
Assistant Director
Orthopaedic Shoulder and Sports Surgery
Naval Medical Center San Diego
San Diego
CA
利益声明
MTP declares that he has no competing interests.
Peter Cundy, MBBS, FRACS
Head of Orthopaedic Surgery
Women's & Children's Hospital
Adelaide
South Australia
Australia
利益声明
PC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Patrick CM, Snowden J, Eckhoff MD, et al. Epidemiology of shoulder dislocations presenting to United States emergency departments: an updated ten-year study. World J Orthop. 2023 Sep 18;14(9):690-7.全文 摘要
Expert Panel on Musculoskeletal Imaging; Laur O, Ha AS, et al. ACR appropriateness criteria® acute shoulder pain: 2024 update. J Am Coll Radiol. 2025 May;22(5S):S36-47.全文 摘要
American College of Radiology. ACR appropriateness criteria: acute hip pain. 2024 [internet publication].全文
Rozzi SL, Anderson JM, Doberstein ST, et al. National Athletic Trainers' Association position statement: immediate management of appendicular joint dislocations. J Athl Train. 2018 Dec;53(12):1117-28.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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