Methodology: 3/5          
Usefulness: 3/5

Secko MA, et al. Ann Emerg Med. 2020 Aug;76(2):119-128.

Question and Methods: Attempted to validated the use of a posterior PoCUS approach in diagnosing shoulder dislocations and assessing the adequacy of reduction in the ED in a multicentre, prospective, observational study.

Findings: PoCUS had 100% sensitivity and specificity in identifying a shoulder dislocation. For overall fractures, PoCUS had 50% sensitivity. For non-Hill-Sachs and non-Bankart lesions, PoCUS had a 92% sensitivity.

Limitations: This study lacked data on excluded patients; was performed in a small sample size; patients were only recruited when trained US fellows were on shift; and PoCUS training for fellows was not described.

Interpretation: Overall, PoCUS has strong sensitivities and specificities for dislocations but has poor sensitivities for fractures. X-Rays are still needed to rule out fractures. In the ED, PoCUS is valuable in assessing for an adequate reduction during procedural sedation.

By: Dr. Darren Wong

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.