Joint dislocations can be sustained during contact sports and physical activities [1] such as football, basketball, wrestling, gymnastics, skiing, etc. Dislocations also occur as a result of a direct blow to the joint during a traffic collision. Additionally, individuals with connective tissue disease tend to have ligamentous laxity and hence may be predisposed to joint dislocation. Individuals susceptible to falls are also prone to this type of injury.

Generally, the clinical presentation of dislocation is characterized by joint deformity, swelling, and discoloration. Moreover, the affected joint exhibits a restricted range of motion and pain with movement. Bruises and abrasions may also be apparent.

The most predominant joint dislocation is that of the glenohumeral, or shoulder joint [2] as a result of its high range of motion [3]. It is responsible for more than half of athletic-related dislocations in high school students [2].

The second most frequently dislocated joint is the elbow [4], in which nearby structures are typically disrupted as well [3].

Also prevalent are finger injuries since the digits are vulnerable to trauma [3]. They are often accompanied by hand and wrist injuries as well [5].

The ankle is a commonly involved site in sports injuries. Specifically, ankle dislocations are typically accompanied by fractures [6].

While rare in sports, hip dislocations are very serious due to complications such as avascular necrosis of the femoral head, which requires urgent medical care [7].

Also uncommon in sports are knee dislocations, which are associated with neurovascular injuries, especially that of the popliteal artery [4] and peroneal nerve [8].

Complications

Dislocated joints may encompass injuries of nearby nerves, blood vessels, ligaments, tendons, and muscles. Also, repaired dislocations may be prone to repeated injuries and the development of arthritis with aging.

Physical exam

The exam consists of numerous components. Initially, the clinician will note findings such as the symmetry, swelling, color, shape, and overall appearance of the affected joint in comparison to the normal one. Very importantly, the joint's range of motion and special maneuvers are also tested. Also crucial is the neurovascular evaluation, which includes a thorough neurologic exam and a check of the pulses. Note that the neurovascular assessment should be performed pre- and post-reduction [3] [9].

• Weakness

  The LCL, therefore, is considered to be the initial weak link in elbow dislocations. In the pediatric population, the clinician should be aware of the 6 ossification centers of the elbow joint as well as the annular ligament. [emedicine.medscape.com]

  A dislocation can cause pain, swelling, and weakness. Your child may also have trouble moving the injured area. An exam and X-rays are often needed to diagnose a dislocation. [hopkinsmedicine.org]

  Surgery may be necessary if you have weak ligaments and the joint tends to dislocate frequently. Next In Understanding Dislocation Basics [webmd.com]

• Hematochezia

  Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself [nejm.org]

• Fracture

  Till now we know two fracture pattern in forearm fracture dislocation, Galeazzi fracture dislocation which is defined as fracture of radial shaft with distal radioulnar joint (DRUJ) dislocation and Monteggia fracture dislocation which is ulnar fracture [ncbi.nlm.nih.gov]

• Arthritis

  Sternoclavicular Hyperostosis Condensing Osteitis 716.81 Friedrick's Disease (aseptic osteonecrosis) Rheumatoid Arthritis Tietze’s syndrome Sternoclavicular Dislocation Complications Pneumothorax Laceration of superior vena cava, pulmonary artery Brachial [eorif.com]

  Also, repaired dislocations may be prone to repeated injuries and the development of arthritis with aging. Physical exam The exam consists of numerous components. [symptoma.com]

  For example, some people with symptoms like yours actually have arthritis or tendonitis. See your doctor so he or she can review your symptoms in detail and perform a thorough joint examination. [sharecare.com]

  Perioperative complications occurred in 8 patients, including one case of acromioclavicular arthritis, one case of delayed distal clavicular fracture at the clavicular hole of the device, 3 cases of clavicular or coracoid button failures, and 3 cases [ncbi.nlm.nih.gov]

  Penn Programs & Services for Joint Dislocation Shoulder and Elbow Our shoulder and elbow specialists treat people who have shoulder or elbow injuries or problems such as arthritis. [pennmedicine.org]

• Joint Subluxation

  Delayed diagnosis and treatment often lead to chronic and persistent lower ulnar joint subluxation or dislocation, or even osteoarthritis. All patients in this report showed great improvement in wrist function after surgery. [ncbi.nlm.nih.gov]

  Joint dislocation (also known as luxation) occurs when the joint surfaces become completely disengaged. A dislocation always damages the ligaments. Joint subluxation is an incomplete/partial dislocation of a joint. [orthopaedicsone.com]

  The injuries to the shoulder may involve acromioclavicular joint subluxations and dislocations (mainly type 1 and 2). [shoulderdoc.co.uk]

  All of the following are true EXCEPT: Review Topic QID: 486 1 Anatomic reconstruction of the articular surface is prognostic of clinical function 2 Proximal interphalangeal joint subluxation precludes a normal gliding flexion arc 3 Hinging at the fracture [orthobullets.com]

• Contusion

  (A subluxation can cause a bone contusion or stretching of the ligaments; a full tear is less likely.) [orthopaedicsone.com]

  We reported a 14-year-old boy who suffered traumatic displacement of the right knee and contusion of the popliteal artery during motorcycle accident. [ncbi.nlm.nih.gov]

  […] plain film imaging, a rare however necessary consideration, best demonstrated on cross sectional imaging 7 Associations SCJ dislocations are associated with the following injuries 3 : anterior dislocation pneumothorax hemothorax rib fractures pulmonary contusion [radiopaedia.org]

  Often the result of a direct contusion to the apex of the shoulder after a fall or a forceful collision with a hard surface. It is common among rugby and ice hockey players as well as bicycle or motorcycle accidents. [shoulderdoc.co.uk]

  These include the following: Nerve injuries - The brachial plexus, axillary nerve, or musculocutaneous nerve may be injured; neurapraxias (contusions of the nerve) usually resolve within weeks Suspected major arterial injury - Urgent angiography is required [emedicine.medscape.com]

• Joint Stiffness

  Intense pain Joint instability Deformity of the joint area Reduced muscle strength Bruising or redness of joint area Difficulty moving joint Stiffness Joint dislocations are caused by trauma to the joint or when an individual falls on a specific joint [en.wikipedia.org]

  Damaged cartilage tends to scar, causing osteoarthritis, which makes joints stiff and limits their range of motion. The knee, elbow, and shoulder are particularly likely to become stiff after an injury, especially in older people. [msdmanuals.com]

  Complications of the dislocation itself include the following: Joint stiffness and functional incapacity Inferior dislocation An estimated 50-60% of patients with luxatio erecta have associated brachial plexus injury. [12] Assessment and documentation [emedicine.medscape.com]

• Facial Pain

  Shortly after TEE and DCCV, the patient complained of bilateral facial pain. An orthopantomogram revealed bilateral TMJ dislocation. A closed reduction was performed by maxillo-facial surgeons under intravenous anaesthesia. [ncbi.nlm.nih.gov]

• Dizziness

  […] prevent dislocation by: Being careful to avoid falls: Keep walkways free of things that can make you trip Use glasses or contacts so you can be aware of your surroundings Keep your home well lit Be aware of the side effects of medicine that could make you dizzy [intermountainhealthcare.org]

  They are more likely to have side effects of drugs (such as drowsiness, loss of balance, and dizziness), which can make falls more likely. Other injuries tend to accompany a dislocation more often in older people. [msdmanuals.com]

  Ask your doctor or pharmacist if any of the drugs you take might make you dizzy. Be sure your home is well-lighted and that you remove any potential tripping hazards from the areas where you walk. Play safely. [mayoclinic.org]

• Agitation

  She was agitated and unable to close her mouth, speak or eat ( Fig. 1 ). The dislocation was manually reduced without sedation and the next day using intravenous midazolam following further dislocation. [nature.com]

  For example, ACTH, prednisone and other steroids are known to cause issues with immunosuppression, hypertension, glucose, gastric issues, agitation and irritability. [rarediseases.org]

• Vertigo

  A 36-year-old female was referred with a history of numbness of the extremities, vertigo and neck pain for 1 year. The patient had no history of trauma. The axial rotation of range of motion of the cervical spine was severely restricted. [ncbi.nlm.nih.gov]

  In Dam’s proving one could see, apart from the general milk themes, symptoms like hyperventilation and tetany: fainting, vertigo with falling backward or forward, numbness of hands and twisting the fingers. [interhomeopathy.fr]

• Stroke

  However, these drugs may have side effects, like an increased risk of bleeding and ulcers or heart attacks and strokes. They should not be used for extended periods of time, unless your doctor specifically says otherwise. [webmd.com]

  […] therapy is also an option in those patients who suffer from recurrent dislocation of the TMJ as a result of impaired muscle coordination, secondary to oromandibular dystonia, neuroleptically-induced early and late dyskinesias, epilepsy, and brainstem stroke [ncbi.nlm.nih.gov]

The workup for joint dislocation consists of the patient's history, physical exam, and the appropriate imaging. Very importantly, the clinician should elicit a detailed account regarding the incident and mechanism of injury.

Shoulder dislocation is best diagnosed with radiography, particularly the anteroposterior (AP), axillary lateral, and scapular Y-views [1]. Other modalities such as ultrasonography may be required to rule out fractures [10].

To evaluate an elbow dislocation, AP and lateral radiographs are obtained prior to and after reduction to ensure the neurovascular status is sound and the reduction is successful. Ultrasonography [11] and computed tomography (CT) imaging are helpful in assessing other structures.

A digit dislocation is identified with pre and post-reduction radiographs with AP, true lateral, and oblique views [12].

An ankle dislocation is examined with AP, lateral and oblique radiographic views before and after reduction. Additionally, CT scanning is used for display of fractures and alignment.

In traumatic cases, the hips are evaluated with an AP radiograph and CT scanning of the pelvis and hips. Lateral views or CT imaging are warranted in cases with negative AP film but dislocation is still suspected [13].

Knee assessment is conducted with radiography prior to ligament stress tests and after reduction [14]. Also, duplex ultrasonography detects the presence vascular injury [15].

Early surgical treatment is recommended for patients with unsatisfactory reset. Delayed diagnosis and treatment often lead to chronic and persistent lower ulnar joint subluxation or dislocation, or even osteoarthritis. [ncbi.nlm.nih.gov]

Overall, the prognosis of trapeziometacarpal dislocation treated acutely is favorable and stable over time. However, the role of open surgery and ligament reconstruction remains controversial, especially in children. [ncbi.nlm.nih.gov]

[…] superior displacement of the clavicle indicates an anterior dislocation 6 difficult to determine anterior or posterior dislocation CT joint space widening and asymmetry at the sternoclavicular joint associated injuries of the mediastinum Treatment and prognosis [radiopaedia.org]

What is the prognosis and life expectancy for West syndrome? Due to the various causes of West syndrome, each individual will have a somewhat different prognosis. [medicinenet.com]

RESULTS: The most common etiologies in the SSF group were fall (n = 3) and direct ear trauma (n = 3), and for those in the ISD group, the most common etiology was traffic accident (n = 6). [ncbi.nlm.nih.gov]

Metabolic etiologies are a rare but important cause [epilepsydiagnosis.org]

The list of etiologies can be subdivided into prenatal disorders, perinatal disorders, and postnatal disorders. [emedicine.medscape.com]

[…] encounter A- initial encounter D- subsequent encounter S- sequela Sternoclavicular Dislocation ICD-9 839.61(dislocation of sernum; sternoclavicular joint: closed) 839.71(dislocation of sernum; sternoclavicular joint: open) Sternoclavicular Dislocation Etiology [eorif.com]

Etiology The aetiology of the syndrome is variable. Cerebral anomalies are detected in 70-80% of cases. [orpha.net]

This study examines the epidemiological characteristics of patients presenting for emergency care of finger dislocations within the United States. [doi.org]

We present an up-to-date literature review on the epidemiology, clinical presentation, radiologic assessment, treatment options and prognostic factors of these uncommon injuries. [ncbi.nlm.nih.gov]

Lower limb injuries in New Zealand Defence Force personnel: descriptive epidemiology. Aust N Z J Public Health. 2008 ;32(2): 167 – 173. Google Scholar | Crossref | Medline | ISI 8. [ajs.sagepub.com]

The pathophysiology, treatment, and diagnosis of PSCJD are discussed. [ncbi.nlm.nih.gov]

[…] develop but usually resolves with therapy more commonly seen in volar dislocations swan neck deformity occurs secondary to a volar plate injury seen in dorsal dislocations extensor lag seen in volar dislocations PIP Fracture-Dislocations Introduction Pathophysiology [orthobullets.com]

[…] is always detached (usually from middle phalanx) in PIP dorsal dislocations; - distal avulsion of volar plate in dorsal PIP dislocations makes entrapment of plate w/in the joint unlikely (in contrast to MP joint in which complex dorsal dislocations prevent [wheelessonline.com]

Eminectomy, whose validity has been demonstrated by several authors, acts on the bony obstacle, preventing condylar locking, but does not have a therapeutic effect on TMJ ligament and capsular laxity or masticatory muscle incoordination, which seem to [ncbi.nlm.nih.gov]

You can prevent a dislocation if you practice safe behavior. General tips to prevent dislocations include: Use handrails when going up and down staircases. Keep a first aid kit in the area. Use nonskid mats in wet areas, such as bathrooms. [healthline.com]

1. Sofu H, Gürsu S, Koçkara N, et al. Recurrent anterior shoulder instability: Review of the literature and current concepts. World J Clin Cases. 2014; 2(11):676-682.
2. Benjamin HJ, Hang BT. Common acute upper extremity injuries in sports. Clin Pediatric Emerg Med. 2007;8(1):15-30.
3. Skelley NW, McCormick JJ, Smith MV. In-game Management of Common Joint Dislocations. Sports Health. 2014;6(3):246-255.
4. Hodge DK, Safran MR. Sideline management of common dislocations. Curr Sports Med Rep. 2002;1(3):149-155.
5. Elfar JC, Yaseen Z, Stern PJ, Kiefhaber TR. Individual finger sensibility in carpal tunnel syndrome. J Hand Surg Am. 2010;35(11):1807-1812.
6. Title CI, Katchis SD. Traumatic foot and ankle injuries in the athlete. Orthop Clin North Am. 2002;33(3):587-598.
7. Smith MV, Sekiya JK. Hip instability. Sports Med Arthrosc. 2010;18(2):108-112.
8. Niall DM, Nutton RW, Keating JF. Palsy of the common peroneal nerve after traumatic dislocation of the knee. J Bone Joint Surg Br. 2005;87(5):664-667.
9. Cohen MS, Hastings H-II. Acute elbow dislocation: evaluation and management. J Am Acad Orthop Surg. 1998;6(1):15-23.
10. Akyol C, Gungor F, Akyol AJ, et al. Point-of-care ultrasonography for the management of shoulder dislocation in ED. Am J Emerg Med. 2016; 34 (5):866-70.
11. Lee KS, Rosas HG, Craig JG. Musculoskeletal ultrasound: elbow imaging and procedures. Semin Musculoskelet Radiol. 2010; 14(4):449-60.
12. Gilbert TJ, Cohen M. Imaging of acute injuries to the wrist and hand. Radiol Clin North Am. 1997; 35(3):701-25.
13. Wylie JD, Abtahi AM, Beckmann JT, Maak TG, Aoki SK. Arthroscopic and imaging findings after traumatic hip dislocation in patients younger than 25 years of age. J Hip Preserv Surg. 2015;2(3):303-9.
14. Bouaicha S. The acute knee injury - practical considerations. Praxis (Bern 1994). 2014;10(8):439-44.
15. Knudson MM, Lewis FR, Atkinson K, Neuhaus A. The role of duplex ultrasound arterial imaging in patients with penetrating extremity trauma. Arch Surg. 1993; 128(9):1033-7; discussion 1037-8.