Time to Diagnosis of Glenohumeral Joint Dislocations in the ED- Traditional Radiography vs. POC Ultrasound

Study Overview
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Brief Summary
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This is study to compare the time to diagnosis of glenohumeral joint dislocation using two imaging methods, traditional x-ray and point-of-care ultrasound. Participants who present at the emergency department complaining of shoulder injury and who are suspected of having a possible glenohumeral shoulder dislocation will be eligible for the study. A reduction of the joint will be performed if imaging findings so indicate. All participants will receive a post-reduction x-ray and be referred to appropriate follow-up care.

Detailed Description
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This is a prospective comparison study evaluating the time to diagnosis of glenohumeral joint dislocation using two imaging modalities, traditional x-ray and point-of-care ultrasound. Eligible participants will include those who present to the emergency department with complaints of shoulder injury who are suspected by triage nursing of having a possible glenohumeral shoulder dislocation. Eligible participants will be consented by participating physicians and randomized into ultrasound or x-ray groups. If indicated based on the imaging findings, a reduction of the joint will be performed. All patients will receive a post-reduction x-ray and be referred to appropriate follow-up care based on the findings of their evaluation.

Official Title
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Time to Diagnosis of Glenohumeral Joint Dislocations in the Emergency Department- Traditional Radiography Versus Point-of-care Ultrasound

Conditions
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Glenohumeral Dislocation

Intervention / Treatment
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* Procedure: Shoulder reduction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients (19 and older in state of Nebraska) who present to the emergency department with shoulder pain/injury and potential shoulder dislocation Exclusion Criteria: Injury sustained in major traumatic event (trauma activation), unable to consent, in extremis, less then 19 years of age

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Prospective randomized diagnostic comparison study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ultrasound<br>After randomization, these subjects will undergo diagnostic point-of-care ultrasound | Procedure: Shoulder reduction<br>* This is standard of care and only measure as a time component outcome in the study<br>|
| Active Comparator: Radiograph<br>After randomization, these subjects will undergo diagnostic plain radiograph | Procedure: Shoulder reduction<br>* This is standard of care and only measure as a time component outcome in the study<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to diagnosis of glenohumeral joint dislocations | Comparison between point-of-care ultrasound and plain radiograph in time to diagnosis of glenohumeral joint dislocations who present to the emergency department | 0 to 60 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to reduction of dislocation joint | Time from presentation in Emergency Department to treatment (reduction of joint dislocation) | 1 to 6 hours | 
| Emergency Department Length of Stay | Total time in Emergency Department | 1 to 12 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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glenohumeral dislocation, POC Ultrasound, Plain radiograph