Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
Diagnostic Accuracy of Ultrasound for Identifying Shoulder Dislocations and Reductions: A Systematic Review of the Literature
- Author(s): Gottlieb, Michael
- Russell, Frances
- et al.
Published Web Locationhttps://doi.org/10.5811/westjem.2017.5.34432
Introduction: Patients with shoulder dislocations commonly present to the emergency department.Ultrasound has the potential to save time, radiation exposure, healthcare costs, and possibleneed for re-sedation. We conducted this systematic review to compare the diagnostic accuracy ofultrasound compared with plain radiography in the assessment of shoulder dislocations.
Methods: We searched PubMed, Scopus, the Cochrane Database of Systematic Reviews,and the Cochrane Central Register of Controlled Trials for relevant trials. Primary data and testcharacteristics were obtained for all included studies. We used QUADAS-2 to assess study quality.Meta-analysis was not performed due to significant heterogeneity.
Results: Four studies met our inclusion criteria, comprising 531 assessments with 202 dislocations.Most studies had a sensitivity of 100% for identifying dislocations. One study demonstrated asensitivity of 54%, and another had only one dislocation that was misidentified. All studies were100% specific for detecting dislocation.
Conclusion: Ultrasound may be considered as an alternative diagnostic method for the detectionof shoulder dislocation and reduction, but further studies are necessary before routine use. [West JEmerg Med. 2017;18(5)937-942.]