Hip Dislocation in Emergency Medicine Differential Diagnoses

  • Author: Edward T Tham, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP   more...
 
Updated: Dec 6, 2010
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Edward T Tham, MD  Fellow in Emergency Ultrasound, Clinical Instructor, Department of Surgery, Section of Emergency Medicine, Yale University School of Medicine

Edward T Tham, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Coauthor(s)

Christopher I Doty, MD, FACEP, FAAEM  Assistant Professor of Emergency Medicine, Residency Program Director, Department of Emergency Medicine, Kings County Hospital Center, State University of New York Downstate Medical Center

Christopher I Doty, MD, FACEP, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

James E Keany, MD, FACEP  Medical Director, TravelMDAssist; Staff Physician, Department of Emergency Services, Mission Hospital Regional Medical Center

James E Keany, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, and California Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Eric L Legome, MD  Chief, Department of Emergency Medicine, Kings County Hospital Center; Associate Professor, Department of Emergency Medicine, New York Medical College

Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP  Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Jerome FX Naradzay, MD, Paul Carter, MD, and Edward Newton, MD, to the development and writing of this article.

References

  1. [Guideline] DeSmet AA, Dalinka MK, Alazraki NP, Daffner RH, El-Khoury GY, Kneeland JB, et al. Avascular necrosis of the hip. [online publication]. Reston (VA): American College of Radiology (ACR); 2005. [Full Text].

  2. [Guideline] United States Preventive Services Task Force (USPSTF). Screening for developmental dysplasia of the hip: recommendation statement. 2006;[Full Text].

  3. Brooks RA, Ribbans WJ. Diagnosis and imaging studies of traumatic hip dislocations in the adult. Clin Orthop Relat Res. Aug 2000;(377):15-23. [Medline].

  4. Conway WF, Totty WG, McEnery KW. CT and MR imaging of the hip. Radiology. Feb 1996;198(2):297-307. [Medline].

  5. DeLee JC. Fracture and dislocation of the hip. In: Rockwood CA, Green DP, Bucholz RW, et al, eds. Fractures in Adults. 4th ed. Lippincott Williams & Wilkins; 1996:1756-803.

  6. Frazee BW, Park RS, Lowery D, et al. Propofol for deep procedural sedation in the ED. Am J Emerg Med. Mar 2005;23(2):190-5. [Medline].

  7. Goddard NJ. Classification of traumatic hip dislocation. Clin Orthop Relat Res. Aug 2000;11-4. [Medline].

  8. Goulet J. Hip dislocation. In: Browner B, ed. Skeletal Trauma: Basic Science, Management and Reconstruction. 3rd ed. Philadelphia, PA: Elsevier Science; 2003:chap 46.

  9. Hillyard RF, Fox J. Sciatic nerve injuries associated with traumatic posterior hip dislocations. Am J Emerg Med. Nov 2003;21(7):545-8. [Medline].

  10. Introduction: congenital hip dislocation. WrongDiagnosis Web site. Available at http://www.wrongdiagnosis.com/c/congenital_hip_dislocation/intro.htm. Accessed May 29, 2003.

  11. McNamara R. Management of common dislocation: hip dislocations. In: Roberts J, Hedges J, eds. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, PA: W. B. Saunders Co; 2004:Chap 50.

  12. Miner JR, Martel ML, Meyer M, et al. Procedural sedation of critically ill patients in the emergency department. Acad Emerg Med. Feb 2005;12(2):124-8. [Medline].

  13. Monma H, Sugita T. Is the mechanism of traumatic posterior dislocation of the hip a brake pedal injury rather than a dashboard injury?. Injury. Apr 2001;32(3):221-2. [Medline].

  14. Morrey BF. Instability after total hip arthroplasty. Orthop Clin North Am. Apr 1992;23(2):237-48. [Medline].

  15. Newton E. Femur and hip. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, PA: Mosby Elsevier; 2006:chap 53.

  16. Nordt WE 3rd. Maneuvers for reducing dislocated hips. A new technique and a literature review. Clin Orthop Relat Res. Mar 1999;260-4. [Medline].

  17. Pitetti RD, Singh S, Pierce MC. Safe and efficacious use of procedural sedation and analgesia by nonanesthesiologists in a pediatric emergency department. Arch Pediatr Adolesc Med. Nov 2003;157(11):1090-6. [Medline].

  18. Sahin V, Karakas ES, Aksu S, et al. Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. J Trauma. Mar 2003;54(3):520-9. [Medline].

  19. Walden PD, Hamer JR. Whistler technique used to reduce traumatic dislocation of the hip in the emergency department setting. J Emerg Med. May-Jun 1999;17(3):441-4. [Medline].

  20. Yang EC, Cornwall R. Initial treatment of traumatic hip dislocations in the adult. Clin Orthop Relat Res. Aug 2000;24-31. [Medline].

 
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A normal anteroposterior (AP) pelvis radiograph.
Right posterior hip dislocation in a young woman following a high-speed motor vehicle collision (MVC).
Fracture-dislocation of the right hip. The bony fragments are likely part of the acetabulum.
Posterior dislocation of right hip with acetabular fracture.
 
 
 
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