User:Cindyshiweinschenk/sandbox

Article evaluation *** Good resource:
 * No information in the "Diagnosis" section
 * Information on how joint dislocations are described (ex. usually the direction of the most distal bone)
 * Expansion of the "Causes" section, may consider going into more detail in regards to the most commonly dislocated joints
 * Strengthen citations with more orthopedic and radiology-specific sources
 * Add citation at end of 2nd paragraph if possible.

https://www.ncbi.nlm.nih.gov/pubmed/24790695

Joint dislocation diagnosis

Initial evaluation of a suspected joint dislocation should begin with a thorough patient history, including mechanism of injury, and physical examination. Special attention should be focused on neurovascular exam both before and after reduction, as injury to these structures may occur during the injury or during the reduction process. Subsequent imaging studies are frequently obtained to assist with diagnosis.
 * Standard plain radiographs, usually a minimum of 2 views
 * Generally, pre- and post-reduction X-rays are recommended. Initial X-ray can confirm the diagnosis as well as evaluate for any concomitant fractures. Post-reduction radiographs confirm successful reduction alignment and can exclude any other bony injuries that may have been caused during the reduction procedure.
 * In certain instances if initial X-rays are normal but injury is suspected, there is possible benefit of stress/weight-bearing views to further assess for disruption of ligamentous structures and/or need for surgical intervention. This may be utilized with AC joint separations.
 * Nomenclature: Joint dislocations are named based on the distal component in relation to the proximal one.
 * Ultrasound
 * Ultrasound may be useful in an acute setting, particularly with suspected shoulder dislocations. Although it may not be as accurate in detecting any associated fractures, in one observational study ultrasonography identified 100% of shoulder dislocations, and was 100% sensitive in identifying successful reduction when compared to plain radiographs. Ultrasound may also have utility in diagnosing AC joint dislocations.
 * In infants <6 months of age with suspected developmental dysplasia of the hip (congenital hip dislocation), ultrasound is the imaging study of choice as the proximal femoral epiphysis has not significantly ossified at this age.
 * Cross-sectional imaging (CT or MRI)
 * Plain films are generally sufficient in making a joint dislocation diagnosis. However, cross-sectional imaging can subsequently be used to better define and evaluate abnormalities that may be missed or not clearly seen on plain X-rays. CT is useful in further analyzing any bony aberrations, and CT angiogram may be utilized if vascular injury is suspected. In addition to improved visualization of bony abnormalities, MRI permits for a more detailed inspection of the joint-supporting structures in order to assess for ligamentous and other soft tissue injury.