Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- postura característica da articulação
- dor
- incapacidade de mover a articulação
- sensibilidade
- edema
- lesão do nervo ciático com luxação do quadril
- lesão da artéria, veia ou nervo femoral com luxação do quadril
- lesão concomitante com luxação do quadril
- lesão do ligamento cruzado com luxação patelar
- rupturas do menisco com luxação patelar
- lesões dos ligamentos do joelho com luxação patelar
- ruptura do tendão patelar ou do quadríceps com luxação patelar
Other diagnostic factors
- equimoses com luxação do dedo
- hemartrose com luxação patelar
Risk factors
- atividades esportivas
- acidente com veículo automotor (luxação do quadril)
- frouxidão ligamentar
- Síndrome de Ehlers-Danlos
- homens entre a adolescência e 30 anos de idade
- sexo feminino com idade de 61 a 80 anos (luxação de ombro)
- história prévia de instabilidade na articulação
- displasia esquelética ou muscular
- ângulo Q alto (luxação patelar)
- torção tibial externa (luxação patelar)
- patela alta (luxação patelar)
Diagnostic tests
1st tests to order
- radiografia simples do ombro
- radiografia simples do dedo
- radiografia simples do joelho
- radiografia simples do cotovelo
- radiografia simples da pelve
Tests to consider
- ressonância nuclear magnética (RNM) do joelho
- RNM do ombro
- tomografia computadorizada (TC) do cotovelo
- TC da pelve
- arteriografia do joelho ou ombro
Emerging tests
- ultrassonografia do ombro
Treatment algorithm
luxação do ombro
luxação do dedo
luxação patelar
luxação do cotovelo
luxação do quadril
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 Safety Monitoring Board for Aesculap and is a paid consultant for Arthrex, Inc., Emovi, ConMed, Icarus, JRF, and LinX Robotics. He has patents with Arthrex, Inc. 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.
Disclosures
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.
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.
References
Key articles
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.Full text Abstract
Expert Panel on Musculoskeletal Imaging: Amini B, Beckmann NM, et al. ACR appropriateness criteria: shoulder pain-traumatic. J Am Coll Radiol. 2018 May;15(5s):S171-88.Full text Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
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