Title : Imaging adherence in shoulder dislocation: Evaluating compliance with rotator cuff tear guidelines in the NHS
Abstract:
Traumatic anterior shoulder dislocation is the most common large joint dislocation and is associated with a high risk of rotator cuff tears in patients aged 40–60 years. National guidelines recommend routine imaging in this cohort to guide management.This re-audit evaluated adherence to imaging guidelines at St Mary’s Hospital between 2018 and 2025, following earlier interventions including staff education and implementation of a standardised referral pathway via the Virtual Fracture Clinic.
Fifty-two patients met inclusion criteria. Overall imaging compliance was 23.1%, with 59.6% referred for orthopaedic follow-up. However, significant improvement was observed over time, with imaging compliance increasing to 100% in 2025 and follow-up rates also reaching full compliance.
These findings demonstrate that targeted interventions can significantly improve adherence to national guidelines. Sustaining these improvements will require continued reinforcement of standardised pathways and optimisation of electronic referral systems. Improved compliance supports earlier detection of rotator cuff tears, reduces missed injuries, and enhances patient outcomes within the NHS.
