title: Bedside ultrasonography for verification of shoulder reduction: A long way to go.
abstract: OBJECTIVE
  Shoulder dislocation is a common joint dislocation managed by the emergency physicians in the emergency departments. Pre- and post-reduction radiographic examinations have long been the standard practice to confirm the presence of dislocation and the successful reduction. However, shoulder ultrasonography has recently been proposed as an alternative to the radiographic examination. This study aimed to assess the accuracy of ultrasonography in evaluating proper reduction of the dislocated joint.
  
  
  METHODS
  This was a prospective observational study. All patients with confirmed anterior shoulder dislocation were examined by both ultrasonography and radiography after the attempt for reduction of the dislocated joint. The examiners were blinded to the result of the other imaging modality. Results of the two methods were then compared.
  
  
  RESULTS
  Overall, 108 patients with confirmed anterior shoulder dislocation were enrolled in the study. Ninety-one (84.3%) of the patients were males. Mean age of the participants was (30.11 ± 11.41) years. The majority of the patients had a recurrent dislocation. Bedside ultrasonography showed a sensitivity of 53.8% (95% CI: 29.1%-76.8%) and a specificity of 100% (95% CI: 96.1%-100%) in detecting inadequate reductions. The results of ultrasonography had a statistically significant agreement with the results of radiography (Kappa = 0.672, p < 0.001).
  
  
  CONCLUSIONS
  The results suggest that the sensitivity of post-reduction ultrasound is not sufficient for it to serve as a substitute for radiography.
authors.affiliation: Emergency Department, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Koorosh
authors.initials: K
authors.lastname: Ahmadi
authors.forename: Amir-Masoud
authors.initials: AM
authors.lastname: Hashemian
authors.forename: Kaveh
authors.initials: K
authors.lastname: Sineh-Sepehr
authors.forename: Monavvar
authors.initials: M
authors.lastname: Afzal-Aghaee
authors.forename: Saba
authors.initials: S
authors.lastname: Jafarpour
authors.forename: Vafa
authors.initials: V
authors.lastname: Rahimi-Movaghar
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D000067716:Point-of-Care Testing; D011446:Prospective Studies; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography