Contents
  • Physical Examination
  • Imaging Studies
  • Ultrasound in Diagnosis
  • Assessing Associated Injuries

Diagnosing Shoulder Dislocations: Beyond the Obvious

Diagnosing Shoulder Dislocations: Beyond the Obvious

More Than Meets the Eye

While a dislocated shoulder may seem obvious, proper diagnosis involves more than just looking at the joint. Accurate assessment is crucial for appropriate treatment and to identify any associated injuries.
Contents
  • Physical Examination
  • Imaging Studies
  • Ultrasound in Diagnosis
  • Assessing Associated Injuries

Physical Examination

The first step in diagnosis is a thorough physical exam. Doctors look for visible deformity, swelling, and bruising. They'll gently test range of motion and check for nerve function in the arm and hand. The type of dislocation (anterior, posterior, or inferior) can often be determined by the arm's position.

Imaging Studies

X-rays are the primary imaging tool for confirming shoulder dislocations. They show the position of the bones and can reveal associated fractures. Multiple views are usually taken, including anteroposterior (AP) and axillary views. In some cases, CT scans or MRI may be needed for a more detailed look at soft tissues and complex injuries.
A shoulder dislocation occurs when the upper arm bone pops out of the cup-shaped socket that's part of the shoulder blade. Diagnosis involves physical examination and imaging studies.

Ultrasound in Diagnosis

Bedside ultrasound is becoming increasingly popular for diagnosing shoulder dislocations. It's quick, doesn't use radiation, and can be used to confirm successful reduction. However, it may not detect all associated fractures, so X-rays are still often needed.

Assessing Associated Injuries

Diagnosis doesn't stop at confirming the dislocation. Doctors also look for related injuries like rotator cuff tears, labral injuries (Bankart lesions), and fractures (including Hill-Sachs lesions). These associated injuries can affect treatment plans and long-term outcomes.

FAQs

Are X-rays always necessary?

Not always, but they're recommended in most cases.

Can ultrasound replace X-rays?

It's useful but may miss fractures, so X-rays are often still needed.

How accurate is physical exam alone?

It's often accurate but imaging confirms diagnosis and reveals complications.

What's a Hill-Sachs lesion?

A compression fracture on the humeral head from dislocation.

When is an MRI needed?

To assess soft tissue damage or plan surgery.

A Comprehensive Approach

Accurate diagnosis of shoulder dislocations requires a combination of clinical skills and appropriate imaging to ensure proper treatment.
Think you might have a dislocated shoulder? Let Doctronic guide you through the diagnostic process.
Additional References
  1. Gottlieb M, Russell F. Diagnostic Accuracy of Ultrasound for Identifying Shoulder Dislocations and Reductions: A Systematic Review of the Literature. West J Emerg Med 2017; 18:937.
  2. Hendey GW. Necessity of radiographs in the emergency department management of shoulder dislocations. Ann Emerg Med 2000; 36:108.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.