Luxations/Subluxations of Skeletal System1

(Version:  07/13/05)

Definition: Luxations (Dislocations) and Subluxations (Partial Dislocations) of skeletal system.

Introduction: 

Select a pre-coordinated disorder concept that is a child of  ‘Dislocation of joint’ (108367008) or ‘Subluxation of joint’(263031003) (see root concepts below). 

·       Traumatic Dislocation of Knee Joint (Disorder) 58320001

 

If the pre-coordinated definition does ‘not’ include the  morphology ‘dislocation’ (for luxations) or ‘dislocation, incomplete’ (for subluxations), the morphology should be added.

If no pre-coordinated concept exists, post-coordinate using the closest disorder concept that is a child of ‘Dislocation of Joint’ or ‘Subluxation of Joint’, add the morphology if applicable, and add topography  (see example 3).

Laterality (right, left, or bilateral) may be added to further define the concept where appropriate:

·       Dislocation of Joint (Disorder) 108367008

o      Finding Site (Attribute) 363698007

§       Knee Joint Structure (Finding Site) 49076000

·       Laterality (attribute) 272741003

o      Right (Qualifier value) 24028007

Root Concept (Disorders):

·       Dislocation of Joint (Disorder) 108367008

·       Subluxation of Joint (Disorder) 263031003

 

 

 

 

 

Comments:

  1. Most congenital dislocation and subluxation disorders do not go to a dislocation parent; most go only to congenital anomaly.  Therefore, these should be post-coordinated using the morphology ‘congenital dislocation’ (13810000) (see example 2).
  2. Recurrent dislocations: Choose a child of the root disorder  ‘Recurrent  dislocation of joint’ (5137004), (see example 4).  If not fully defined, add the topography and/or morphology.
  3. Pathologic dislocation:  Choose a child of the root disorder ‘Pathological dislocation of joint’ (80406003), (see example1).  If not fully defined, add the topography and morphology.
  4. Combination fracture dislocation concepts:  When possible, use the pre-coordinated concepts for fracture dislocations.   When this does not exist, it may be post-coordinated using the root ‘Fracture dislocation of joint’ and adding the appropriate topography or morphology if necessary.

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Examples:

 

 

 

Case 1: "Shoulder luxation, pathologic"

Pathological dislocation of shoulder region (disorder) 202167006

 

Case 2: "Lumbosacral congenital dislocation"

 

·       Dislocation of Lumbosacral Joint (Disorder) 129161004

o      Associated morphology (attribute) 116676008

§       Congenital dislocation (morphologic abnormality) 13810000

 

Case 3: "Dislocation of coffin joint of forelimb."

 

·       Dislocation of Joint of Upper Limb (Disorder) 263017003

o      Finding Site (Attribute) 363698007

§       Coffin Joint (Body  Structure) 196392002

Case 4: "Recurrent dislocation of  fetlock joint, hindlimb” *

·       Recurrent Dislocation of Lower Leg (Disorder) 85536008

o      Finding Site (Attribute) 363698007

§       Fetlock Joint (Body Structure) 48201008

*Note:  The pre-coordinated concept in SNOMED for recurrent dislocation of ankle/foot is not a child of Recurrent Dislocation of Lower Leg.   Thus, if this concept is chosen retrievals for children of Recurrent Dislocation of Lower Leg may not result in cases coded as Recurrent Dislocation of Ankle.  We recommend the post-coordination per this example for this reason.

 

 

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1Written by the VMDB Taskforce on Development of SNOMED Guidelines.  The committee wishes to recognize contributions provided by Dr. Jeff Wilcke and Dr. Penny Livesay.