<< Managing Dislocations of the Hip, Knee, and Ankle in the Emergency Department (Trauma CME)

Diagnostic Studies

Hip Dislocation

Initial diagnostic testing for hip dislocations involves x-ray imaging. Trauma patients may be difficult to transport or transfer to an x-ray table for imaging. An initial bedside anteroposterior (AP) pelvis x-ray is appropriate in most cases and will reveal most hip dislocations. (See Figure 6.) Shenton’s line, created by the inferior borders of the superior pubic ramus and neck of the femur, will be abnormal, suggesting dislocation or fracture. If the femoral head is superior to the acetabulum and smaller when compared to the contralateral side, this is likely a posterior dislocation. Alternatively, if the femoral head is inferior to the acetabulum and larger in appearance than the contralateral side, this is likely an anterior dislocation. The lesser trochanter will also be more apparent in anterior dislocations, due to external rotation.4

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