Joint dislocation
Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- 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
Outros fatores diagnósticos
- ecchymosis with finger dislocation
- haemarthrosis with patellar dislocation
Fatores de risco
- 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)
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- 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
Investigações a serem consideradas
- 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
Novos exames
- ultrasound of the shoulder
Algoritmo de tratamento
shoulder dislocation
finger dislocation
patellar dislocation
elbow dislocation
hip dislocation
Colaboradores
Autores
Thomas M. DeBerardino, MD
Division Chief, Sports Medicine
Department of Orthopaedic Surgery
UT Health San Antonio
San Antonio
TX
Declarações
TMD is a paid consultant and receives royalties from Arthrex, Inc. He has contributed to educational events for Arthrex, Inc.
Agradecimentos
Dr Thomas M. DeBerardino would like to gratefully acknowledge Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this topic.
Declarações
PN and BP declare that they have no competing interests.
Revisores
Daniel J. Solomon, MD
Co-director of Orthopedic Sports and Shoulder Service
Department of Orthopedic Surgery
Naval Medical Center San Diego
San Diego
CA
Declarações
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
Declarações
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
Declarações
PC declares that he has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
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.Texto completo Resumo
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.Texto completo Resumo
American College of Radiology. ACR appropriateness criteria: acute hip pain. 2024 [internet publication].Texto completo
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.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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