Conventional Radiograph Is Still Advised in the Diagnostic Work-up of a Shoulder Dislocation; a Letter to the Editor

Abstract

Dear editor:

A shoulder dislocation is a common diagnosis at the emergency department, showing an incidence of 23.9 per 100,000 person-years. In the current diagnostic work-up, a radiograph is often used to confirm the dislocation. As radiographs are associated with radiation exposure, the ultrasound has been proposed as an alternative. Therefore, the study by Entezari et al is of great importance in evaluating the applicability of the ultrasound. However, the authors suggest that the ultrasound can be used as an alternative to the radiograph. In our opinion, an important advantage of the radiograph has not been discussed and we question some decisions that were made in terms of methodology. Therefore, we think that this study has to be seen in the light of these remarks.

1. Zacchilli MA, Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am. 2010;92(3):542-9.
2. Gottlieb M, Holladay D, Peksa GD. Point-of-care ultrasound for the diagnosis of shoulder dislocation: A systematic review and meta-analysis. Am J Emerg Med. 2019;37(4):757-61.
3. Entezari P, Jalili M, Seyedhosseini J, Doosti-Irani A, Mirfazaelian H. Accuracy of Ultrasonography in Diagnosis of Shoulder Dislocation: A Systematic Review. Adv J Emerg Med. 2020;4(1):e9.
4. Auffarth A, Mayer M, Kofler B, Hitzl W, Bogner R, Moroder P, et al. The interobserver reliability in diagnosing osseous lesions after first-time anterior shoulder dislocation comparing plain radiographs with computed tomography scans. J Shoulder Elbow Surg. 2013;22(11):1507-13.
5. Griffith JF, Antonio GE, Yung PS, Wong EM, Yu AB, Ahuja AT, et al. Prevalence, pattern, and spectrum of glenoid bone loss in anterior shoulder dislocation: CT analysis of 218 patients. AJR Am J Roentgenol. 2008;190(5):1247-54.
6. Provencher MT, Bhatia S, Ghodadra NS, Grumet RC, Bach BR, Jr., Dewing CB, et al. Recurrent shoulder instability: current concepts for evaluation and management of glenoid bone loss. J Bone Joint Surg Am. 2010;92 Suppl 2:133-51.
7. Jankauskas L, Rudiger HA, Pfirrmann CW, Jost B, Gerber C. Loss of the sclerotic line of the glenoid on anteroposterior radiographs of the shoulder: a diagnostic sign for an osseous defect of the anterior glenoid rim. J Shoulder Elbow Surg. 2010;19(1):151-6.
8. Gottlieb M, Nakitende D, Krass L, Basu A, Christian E, Bailitz J. Frequency of Fractures Identified on Post-Reduction Radiographs After Shoulder Dislocation. West J Emerg Med. 2016;17(1):35-8.
9. Bernhardson AS, Murphy CP, Aman ZS, LaPrade RF, Provencher MT. A Prospective Analysis of Patients With Anterior Versus Posterior Shoulder Instability: A Matched Cohort Examination and Surgical Outcome Analysis of 200 Patients. Am J Sports Med. 2019;47(3):682-7.
Files
IssueVol 4 No 3 (2020): Summer (July) QRcode
SectionLetter to the editor
Keywords
No Keywords No Keyword
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Verweij L, van der Woude H-J, van den Bekerom M. Conventional Radiograph Is Still Advised in the Diagnostic Work-up of a Shoulder Dislocation; a Letter to the Editor. Front Emerg Med. 2020;4(3):e66.

Downloads

Download data is not yet available.