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Ultrasound of the Shoulder

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Abstract

Ultrasonography utilizes nonionizing radiation to image the shoulder in high resolution. Shoulder pain is common, and rotator cuff abnormalities correlate highly with age. A careful clinical and sonographic examination of the shoulder can result in the diagnosis of shoulder pain in many individuals. The sonographic examination of the shoulder should be systematic and include imaging the rotator cuff tendon and muscles, long head of the biceps tendon, acromio-clavicular joint, as well as associated structures such as joint recesses and bursae. Knowledge of sonoanatomy will allow the practitioner to optimally position the patient to create sonographic windows to examine the various structures. A broad group of rotator cuff and nonrotator cuff pathologies may be depicted as well as manifestations of inflammatory arthropathies.

Keywords

Shoulder ultrasound Rotator cuff Supraspinatus Biceps tendon Subacromial subdeltoid bursa Humeral erosions Posterior recess 

References

  1. 1.
    Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998;57(11):649–55.Google Scholar
  2. 2.
    Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am. 2006;88(8):1699–704.Google Scholar
  3. 3.
    Girish G, Lobo LG, Jacobson JA, Morag Y, Miller B, Jamadar DA. Ultrasound of the shoulder: asymptomatic findings in men. AJR Am J Roentgenol. 2011;197(4):W713–9.Google Scholar
  4. 4.
    Nazarian LN, Jacobson JA, Benson CB, Bancroft LW, Bedi A, McShane JM, et al. Imaging algorithms for evaluating suspected rotator cuff disease: Society of Radiologists in Ultrasound consensus conference statement. Radiology. 2013;267(2):589–95.Google Scholar
  5. 5.
    Teefey SA. Shoulder sonography: why we do it. J Ultrasound Med. 2012;31(9):1325–31.Google Scholar
  6. 6.
    Karthikeyan S, Rai SB, Parsons H, Drew S, Smith CD, Griffin DR. Ultrasound dimensions of the rotator cuff in young healthy adults. J Shoulder Elbow Surg. 2014;23(8):1107–12.Google Scholar
  7. 7.
    Mochizuki T, Sugaya H, Uomizu M, Maeda K, Matsuki K, Sekiya I, et al. Humeral insertion of the supraspinatus and infraspinatus. New anatomical findings regarding the footprint of the rotator cuff. J Bone Joint Surg Am. 2008;90(5):962–9.Google Scholar
  8. 8.
    Martinoli C, Bianchi S, Prato N, Pugliese F, Zamorani MP, Valle M, et al. US of the shoulder: non-rotator cuff disorders. Radiographics. 2003;23(2):381–401. quiz 534.Google Scholar
  9. 9.
    Schmidt WA, Schmidt H, Schicke B, Gromnica-Ihle E. Standard reference values for musculoskeletal ultrasonography. Ann Rheum Dis. 2004;63(8):988–94.Google Scholar
  10. 10.
    Chang KV, Chen WS, Wang TG, Hung CY, Chien KL. Associations of sonographic abnormalities of the shoulder with various grades of biceps peritendinous effusion (BPE). Ultrasound Med Biol. 2014;40(2):313–21.Google Scholar
  11. 11.
    Stegbauer J, Rump LC, Weiner SM. Sites of inflammation in painful rheumatoid shoulder assessed by musculoskeletal ultrasound and power Doppler sonography. Rheumatol Int. 2008;28(5):459–65.Google Scholar
  12. 12.
    Strunk J, Lange U, Kurten B, Schmidt KL, Neeck G. Doppler sonographic findings in the long bicipital tendon sheath in patients with rheumatoid arthritis as compared with patients with degenerative diseases of the shoulder. Arthritis Rheum. 2003;48(7):1828–32.Google Scholar
  13. 13.
    Ejnisman B, Monteiro GC, Andreoli CV, de Castro Pochini A. Disorder of the long head of the biceps tendon. Br J Sports Med. 2010;44(5):347–54.Google Scholar
  14. 14.
    Gothelf TK, Bell D, Goldberg JA, Harper W, Pelletier M, Yu Y, et al. Anatomic and biomechanical study of the biceps vinculum, a structure within the biceps sheath. Arthroscopy. 2009;25(5):515–21.Google Scholar
  15. 15.
    Wall LB, Teefey SA, Middleton WD, Dahiya N, Steger-May K, Kim HM, et al. Diagnostic performance and reliability of ultrasonography for fatty degeneration of the rotator cuff muscles. J Bone Joint Surg Am. 2012;94(12), e83.Google Scholar
  16. 16.
    Kim HM, Dahiya N, Teefey SA, Middleton WD, Stobbs G, Steger-May K, et al. Location and initiation of degenerative rotator cuff tears: an analysis of three hundred and sixty shoulders. J Bone Joint Surg Am. 2010;92(5):1088–96.Google Scholar
  17. 17.
    Jacobson JA, Lancaster S, Prasad A, van Holsbeeck MT, Craig JG, Kolowich P. Full-thickness and partial-thickness supraspinatus tendon tears: value of US signs in diagnosis. Radiology. 2004;230(1):234–42.Google Scholar
  18. 18.
    Gazzola S, Bleakney RR. Current imaging of the rotator cuff. Sports Med Arthrosc. 2011;19(3):300–9.Google Scholar
  19. 19.
    Farin PU, Jaroma H. Sonographic findings of rotator cuff calcifications. J Ultrasound Med. 1995;14(1):7–14.Google Scholar
  20. 20.
    Le Goff B, Berthelot JM, Guillot P, Glemarec J, Maugars Y. Assessment of calcific tendonitis of rotator cuff by ultrasonography: comparison between symptomatic and asymptomatic shoulders. Joint Bone Spine. 2010;77(3):258–63.Google Scholar
  21. 21.
    Daghir AA, Sookur PA, Shah S, Watson M. Dynamic ultrasound of the subacromial-subdeltoid bursa in patients with shoulder impingement: a comparison with normal volunteers. Skeletal Radiol. 2012;41(9):1047–53.Google Scholar
  22. 22.
    Luukkainen R, Sanila MT, Luukkainen P. Poor relationship between joint swelling detected on physical examination and effusion diagnosed by ultrasonography in glenohumeral joints in patients with rheumatoid arthritis. Clin Rheumatol. 2007;26(6):865–7.Google Scholar
  23. 23.
    Bruyn GA, Naredo E, Moller I, Moragues C, Garrido J, de Bock GH, et al. Reliability of ultrasonography in detecting shoulder disease in patients with rheumatoid arthritis. Ann Rheumat Dis. 2008:ard.2008.089243.Google Scholar
  24. 24.
    Zubler V, Mamisch-Saupe N, Pfirrmann CW, Jost B, Zanetti M. Detection and quantification of glenohumeral joint effusion: reliability of ultrasound. Eur Radiol. 2011;21(9):1858–64.Google Scholar
  25. 25.
    Lehtinen JT, Belt EA, Lyback CO, Kauppi MJ, Kaarela K, Kautiainen HJ, et al. Subacromial space in the rheumatoid shoulder: a radiographic 15-year follow-up study of 148 shoulders. J Shoulder Elbow Surg. 2000;9(3):183–7.Google Scholar
  26. 26.
    Alasaarela E, Suramo I, Tervonen O, Lahde S, Takalo R, Hakala M. Evaluation of humeral head erosions in rheumatoid arthritis: a comparison of ultrasonography, magnetic resonance imaging, computed tomography and plain radiography. Br J Rheumatol. 1998;37(11):1152–6.Google Scholar
  27. 27.
    Amin MF, Ismail FM, El Shereef RR. The role of ultrasonography in early detection and monitoring of shoulder erosions, and disease activity in rheumatoid arthritis patients; comparison with MRI examination. Acad Radiol. 2012;19(6):693–700.Google Scholar
  28. 28.
    Sanja MR, Mirjana ZS. Ultrasonographic study of the painful shoulder in patients with rheumatoid arthritis and patients with degenerative shoulder disease. Acta Reumatol Port. 2010;35(1):50–8.Google Scholar
  29. 29.
    Coari G, Paoletti F, Iagnocco A. Shoulder involvement in rheumatic diseases. Sonographic findings. J Rheumatol. 1999;26(3):668–73.Google Scholar
  30. 30.
    Alasaarela EM, Alasaarela EL. Ultrasound evaluation of painful rheumatoid shoulders. J Rheumatol. 1994;21(9):1642–8.Google Scholar
  31. 31.
    Dasgupta B, Cimmino MA, Kremers HM, Schmidt WA, Schirmer M, Salvarani C, et al. Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum. 2012;64(4):943–54.Google Scholar
  32. 32.
    Matteson EL, Maradit-Kremers H, Cimmino MA, Schmidt WA, Schirmer M, Salvarani C, et al. Patient-reported outcomes in polymyalgia rheumatica. J Rheumatol. 2012;39(4):795–803.Google Scholar
  33. 33.
    Macchioni P, Boiardi L, Catanoso M, Pazzola G, Salvarani C. Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica: comparison with the previous criteria in a single-centre study. Ann Rheum Dis. 2014;73(6):1190–3.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Division of RheumatologyUniversity of Florida College of MedicineJacksonvilleUSA

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