title: Point-of-care ultrasonography for the management of shoulder dislocation in ED.
abstract: OBJECTIVE
  Point-of-care ultrasonography (POCUS) is an easily available and noninvasive tool without radiation exposure that is also gaining a broad range of use in emergency departments. The aim of this study is to evaluate the value of POCUS in the diagnosis of shoulder dislocation by comparing with plain radiography.
  
  
  METHODS
  This prospective observational study with a convenience sampling was conducted in emergency departments of 2 hospitals. Patients older than 15 years with possible shoulder dislocation during the physical examination composed the study population. All the study patients underwent POCUS evaluation to detect a shoulder dislocation or fracture before radiography, and the POCUS procedure was also achieved after the reduction attempt.
  
  
  RESULTS
  A total of 103 patients were enrolled in the study. The mean age of study subjects was 33.9±15 years, and 80.6% (n=83) of them were male. The sensitivity and specificity of POCUS in identifying dislocation were 100% (95% confidence interval [CI], 96%-100%) and 100% (95% CI, 48%-100%), respectively. POCUS also confirmed reduction in 93 of 94 patients with a specificity of 100% (95% CI, 96%-100%). POCUS has a sensitivity of 100% (95% CI, 63%-100%) for excluding a shoulder fracture but a specificity of 84.2% (95% CI, 75%-91%).
  
  
  CONCLUSIONS
  Point-of-care ultrasonography is an effective tool to either rule in or rule out shoulder dislocation in the emergency setting. Furthermore, it is a robust sensitive tool for excluding fractures but with false-positive results.
authors.affiliation: Antalya Research and Training Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: drcanakyol@gmail.com.
authors.forename: Can
authors.initials: C
authors.lastname: Akyol
authors.affiliation: Antalya Research and Training Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: drfarukgungor@gmail.com.
authors.forename: Faruk
authors.initials: F
authors.lastname: Gungor
authors.affiliation: Antalya Ataturk Govermental Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: angaja@yahoo.fr.
authors.forename: Angelika Janitzky
authors.initials: AJ
authors.lastname: Akyol
authors.affiliation: Antalya Research and Training Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: mustafakesapli@hotmail.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kesapli
authors.affiliation: Antalya Research and Training Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: ramon.ra.dr@gmail.com.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Guven
authors.affiliation: Antalya Research and Training Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: umutc.cakir@hotmail.com.
authors.forename: Umut
authors.initials: U
authors.lastname: Cengiz
authors.affiliation: Antalya Research and Training Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: htoksul@hotmail.com.
authors.forename: Halil İbrahim
authors.initials: Hİ
authors.lastname: Toksul
authors.affiliation: Akdeniz University Medical Faculty, Department of Emergency Medicine, Antalya, Turkey. Electronic address: cenkereken@akdeniz.edu.tr.
authors.forename: Cenker
authors.initials: C
authors.lastname: Eken
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult