Summary
Definition
History and exam
Key diagnostic factors
- characteristic posturing of joint
- pain
- inability to move joint
- tenderness
- swelling
- normal neurologic 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
- hemarthrosis with patellar dislocation
Risk factors
- sports-related activities
- motor vehicle accident
- ligamentous laxity
- Ehlers-Danlos syndrome
- males between adolescence and 30 years of age
- women ages 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
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
Treatment algorithm
shoulder dislocation
finger dislocation
patellar dislocation
elbow dislocation
hip dislocation
Contributors
Authors
Thomas M. DeBerardino, MD
The San Antonio Orthopaedic Group
San Antonio
TX
Disclosures
TMD is a paid consultant and receives royalties from Arthrex, Inc. He serves on the Data Management Committee for Aesculap and is a paid consultant for Arthrex, Inc. and Emovi. TMD declares that none of these relationships relate to this topic.
Acknowledgements
Dr Thomas M. DeBerardino would like to gratefully acknowledge Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this topic. PN and BP declare that they have no competing interests.
Peer reviewers
Daniel J. Solomon, MD
Co-director of Orthopedic Sports and Shoulder Service
Department of Orthopedic Surgery
Naval Medical Center San Diego
San Diego
CA
Disclosures
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
Disclosures
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
Disclosures
PC declares that he has no competing interests.
Differentials
- Proximal humerus fracture
- Distal clavicle fracture
- Acromioclavicular joint separation
More DifferentialsGuidelines
- ACR appropriateness criteria: osteonecrosis
- ACR appropriateness criteria: acute trauma to the knee
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer