How are Dislocations and Subluxations Diagnosed?

Comprised of the upper arm bone (humerus), shoulder socket (glenoid), and several ligaments that maintain its stability, the shoulder is perhaps the most important joint in the human body, playing a crucial role in mobility and allowing us to perform vital tasks. Due to its positioning and regular use in daily activities, shoulder injuries can frequently occur and range in severity. 

The most common shoulder injuries include subluxations and dislocations. Although they share similarities, both injuries are distinct; while subluxations refer to a partial dislocation where the humerus is only partly shifted from the glenoid cavity, in complete dislocations, the humeral ball is entirely separated from the shoulder socket. 

Subluxations can be more challenging to diagnose than dislocations, although they may be observed due to a protrusion under the skin indicating sustained damage. Individuals may report feeling increased shoulder instability accompanied by discomfort. The most common symptoms include:

  • Joint pain
  • Shoulder swelling
  • Visible deformity 
  • Tingling or numbness along the arm
  • Limited shoulder mobility 

Due to the shoulder joint's ability to rotate in multiple directions, subluxations and dislocations occur downward, forward, or backward, stretching or tearing the glenoid cavity and associated structures. Young individuals and those involved in intense physical activities face the highest risk of subluxations, which are often caused by:

  • Trauma – Includes motor vehicle accidents or falling improperly on an outstretched hand.
  • Sports Injuries – Contact sports like football or hockey, and sports that involve high velocities or falling, like gymnastics or skiing.
  • Stroke – 80% of individuals that experienced a stroke are at risk of subluxations due to muscle weakness that can lead to shoulder instability. 

Considering that both injuries are related, it's no surprise that the symptoms of a complete dislocation are similar to those of subluxations but a lot more increased in severity. Additionally, bruising or redness, muscle spasms, and shoulder immobility may be distinguishing symptoms of a dislocation. 

Just like subluxations, trauma and injuries that occur from sports are the most common causes of shoulder dislocations, including disciplines that require repetitive overhead arm movements, like baseball or tennis. 

When such injuries occur, physicians will cover a patient's symptoms and medical history before performing a physical examination by palpating the affected area. X-rays, CT scans, or MRIs can also be ordered to obtain a better image of the internal shoulder damage and rule out other potential causes of pain or injuries, like:

After determining the injury's extent and severity, physicians may be able to place the shoulder back in its socket on the spot or recommend a care plan consisting of either conservative treatment or surgical intervention