US team develops new guidelines for diagnosing traumatic shoulder injuries


Trainees at Brigham and Women's Hospital Radiology Residency Program have devised new guidelines to help A&E radiologists detect secondary injuries when treating traumatic shoulder injuries.

Shoulder Injury

Traumatic shoulder injuries may also involve secondary injury which emergency room (A&E in the UK) specialists may not detect if they concentrate on the primary injury. This can comprise the overall treatment given, say the team.

The protocols of diagnosing secondary or underlying shoulder injuries will improve patient outcomes and have been awarded the 2012 Gold Medal by the American Roentgen Ray Society (ARRS).

Dr Scott Sheehan – a radiologist resident at Brigham and Women's Hospital who is lead author of the study – said that the severity of traumatic shoulder injuries should not be underestimated.

“Subtle injuries can have significant consequences if not recognised and treated promptly.”

Using different ways of imaging, the researchers demonstrated the types of force and impacts which cause the five most common types of traumatic shoulder injuries – dislocation of the shoulder, proximal humerus fracture, shoulder separation, clavicle fracture and scapula fracture.

They also developed guidelines for using the best imaging techniques to diagnose traumatic shoulder injuries and how imaging could be used to improve diagnosis of traumatic shoulder injuries – for example, the researchers suggested that the best way of diagnosing acute shoulder dislocations is to "address immediate complications and identify risk factors which could lead to the development of chronic shoulder instability."

Dr Sheehan and his team began investigating traumatic shoulder injuries after a colleague sustained a dislocated shoulder and minor associated injuries, which had a serious effect on the patient.

Dr Sheehan said:

“When radiologists understand the common mechanisms of primary shoulder injuries, they can more appropriately direct their attention to the most clinically significant associated secondary bony or soft tissue injuries."

“Early detection of these injuries can ideally lead to improved timeliness of appropriate treatment and ultimately improved functional outcomes.”

“The team received their award at the 2012 ARRS Annual Meeting in Vancouver, Canada.”

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