Ultrasound Application in the Emergency Department for Diagnosing Shoulder Dislocations: A Systematic Review of Accuracy and Efficacy

Due to the urgent nature of shoulder dislocations, traditional methods like radiography and CT scans can cause delays, increasing patient stress and discomfort. Ultrasound, with its speed and accessibility, offers a faster alternative for diagnosis and treatment. However, no comprehensive study has yet evaluated its accuracy and sensitivity. This systematic review aims to assess the accuracy and sensitivity of ultrasound in emergency departments. This study is a systematic review conducted based on the PRISMA guidelines, aiming to evaluate the accuracy and sensitivity of ultrasound in diagnosing shoulder dislocations in emergency departments. Searches were performed in reputable domestic and international databases, including PubMed, Scopus, Google Scholar, SID, IranMedex, and Magiran. The search covered articles published in both English and Persian, with no time limitations. The "Quality Assessment of Diagnostic Accuracy Studies 2" (QUADAS-2) tool was used to assess the quality of the included studies. Statistical analyses, including random-effects models and sROC curve analysis, were conducted using the MIDAS and DIAGT modules in StataMP, and forest plots were generated with RevMan software. This study examined 12 articles to assess the diagnostic accuracy of ultrasound in diagnosing shoulder dislocation in the emergency department, with 1,522 participants. The pooled effect size for specificity was 1.10 (95% CI: 1.02–1.18, p = 0.0001), and for sensitivity, it was 15.1 (95% CI: 1.03–1.36, p = 0.0001), both indicating high accuracy. Heterogeneity was low (I 2 = 30%), and funnel plot analysis showed minimal publication bias, confirming ultrasound’s reliability in clinical practice. ultrasound demonstrates high diagnostic accuracy for shoulder dislocation in emergency departments, with excellent specificity and sensitivity. The findings support its reliability and effectiveness as a diagnostic tool in clinical practice, with minimal heterogeneity and publication bias.