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Ultrasound-Guided Intra-articular Lidocaine Block for Reduction of Anterior Shoulder Dislocation in the Pediatric Emergency Department

Breslin, Kristen MD*; Boniface, Keith MD, RDMS; Cohen, Joanna MD*

doi: 10.1097/PEC.0000000000000095
Ultrasound Case Reviews

We report a case of successful reduction of an anterior shoulder dislocation after ultrasound-guided intra-articular lidocaine (IAL) block with subsequent sonographic confirmation of reduction. Current literature suggests that IAL can provide similar levels of analgesia as intravenous sedation, and IAL block is associated with lower complication rates and shorter emergency department stays. However, these studies may be limited by uncertainty about the accuracy of landmark-based glenohumeral injections. The use of beside ultrasound may improve the effectiveness of IAL block for reduction of anterior shoulder dislocation and provide a mechanism for immediate postreduction evaluation of the placement of the humeral head.

From the *Division of Emergency Medicine, Children’s National Medical Center; and †Department of Emergency Medicine, George Washington University, Washington, DC.

Disclosure: The authors declare no conflict of interest.

Reprints: Kristen Breslin, MD, Division of Emergency Medicine, Children’s National Medical Center, 111 Michigan Ave NW, Washington, DC 20010 (e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.