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Current RMA Instruments
|Reasonable Hypothesis SOP||24 of 2010|
|Balance of Probabilities SOP||25 of 2010|
Changes from previous Instruments
- ICD-9-CM Codes: 831.04, 831.1, 831.10, 831.14,832-834,837-838,839.2,839.3,839.30,839.41-839.49,839.5,835.52,839.59,839.6-839.7
- ICD-10-AM Codes: M24.3, M99.1, S03.0, S33.1, S33.2, S33.3, S43.1, S43.2, S43.3, S53.0, S53.1, S63.0, S63.1, S63.2, S93.0, S93.1, S93.3
This SOP covers one-off episodes of dislocation or subluxation (partial dislocation) of a joint. Recurrent dislocation is covered by the joint instability SOP.
Confirming the diagnosis
The diagnosis can be made on clinical grounds, but there will often have been an X-ray taken to confirm the precise nature of the dislocation and whether there has been any associated injury/ fracture. Such evidence should be obtained where available.
The relevant medical specialist is an orthopaedic surgeon.
Additional diagnoses that are covered by this SOP
- Subluxation, or partial dislocation of the joint
- Closed, compound, or complicated dislocation
- Fracture-dislocation of a joint - see comments below
- Labral tear occurring in conjunction with acute traumatic dislocation - see comments below
Conditions that are not covered by this SOP
- Congenital dislocation
- Recurrent dislocation* - joint instability SOP
- Dislocation of lens of eye, ICD code 379.32-4
* another SOP applies - the SOP has the same name unless otherwise specified
A dislocation is an acute event associated with immediate symptoms (particularly pain) and deformity of the joint. Clinical onset will be at the time of the acute event. In subluxation there is no persisting deformity and so clinical onset will be based on self-report of a joint going "out of place" with associated pain.
For worsening, the SOP has only an inability to obtain appropriate clincial management factor. Lack of appropriate management could lead to sequelae / other consequences (warranting separate diagnoses), but it is diffiuclt to envisage how there could be worsening of the dislocation per se.
When an acute traumatic dislocation of a joint is associated with other damage to the same joint, from the same acute injury mechanism, such as an articular fracture or a labral tear (shoulder or hip), the other damage can either be determined separately, using the relevant SOP (fracture, labral tear) or a combined diagnostic label can be used and the injury determined as one condition using the dislocation SOP.