Accuracy of point-of-care ultrasound using low frequency curvilinear transducer in the diagnosis of shoulder dislocation and confirmation of appropriate reduction

Javad Seyedhosseini; Jaleh Saiidian; Amirpejman Hashemi Taheri; Elnaz Vahidi

doi:10.1016/j.tjem.2017.07.002

Javad Seyedhosseini¹, Jaleh Saiidian¹, Amirpejman Hashemi Taheri², Elnaz Vahidi¹

¹Tehran University of Medical Sciences, Shariati Hospital, Emergency Medicine Research Center, Iran
²Tehran University of Medical Sciences, Shariati Hospital, Radiology Department, Iran

Keywords: Shoulder dislocation, Reduction, Ultrasound, Radiography

Abstract

Background: Ultrasound (US) is an effective modality in the evaluation of shoulder dislocation and reduction. In most studies, high frequency US probes have been used.

Objective: To determine the sensitivity and specificity of low frequency US in the diagnosis of shoulder dislocation and its proper reduction in the emergency department (ED).

Methods: In a prospective observational study 84 patients, suspicious of shoulder dislocation, were enrolled in our study. In ED, they all underwent low frequency (curve) probe US examination by the emergency physician at the time of admission. Standard radiographies of their shoulder joints were taken later and then reported by the attending radiologist. As soon as the shoulder dislocation was confirmed, reduction of the joint was done under procedural sedation and analgesia. US and radiography of the relocated joint were taken for the second time. The sensitivity and specificity of low frequency US were compared with radiography by the appropriate statistical analysis.

Results: In comparison to radiography, US had a sensitivity of 100.0%, specificity of 80.0%, positive predictive value of 98.7%, and negative predictive value of 100.0% in diagnosis of shoulder dislocation. The specificity of US in diagnosis of proper reduction of the joint, was estimated to be 98.7% with a negative predictive value of 100.0%. US took a significantly less time than radiography to be performed (p < 0.001).

Conclusions: Low frequency US is highly accurate in diagnosing shoulder dislocation and its proper reduction. Thus it might be a good substitute for radiography in these situations.