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].

• 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]

• Right Shoulder Pain

  He presented with right shoulder pain, right upper limb functional impairment and right sternoclavicular joint depression. Standard chest radiographs were normal. Chest CT scan showed posterior dislocation and allowed us to determine its variety. [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].

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