A SONOGRAPHIC CASE REVIEW OF PATHOLOGIES AROUND THE SHOULDER JOINT
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Abstract
The shoulder is one of the most problematic musculoskeletal regions and can generate pain and disability when associated with pathologies of rotator cuff (RC) or non-rotator cuff (NRC) structures. Musculoskeletal ultrasound (US) has become an important diagnostic tool to visualize these entities in a dynamic, real-time and cost-efficient manner compared to other imaging options, such as MRI or arthroscopy.
Ultrasound can confidently identify key findings such as fluid in the anatomical bursae or joint, changes in the symmetry of a torn bursa, and thinning and disruption of rotator cuff tendons.
Our pictorial review showed partial and full tears of the infraspinatus and supraspinatus tendons, impingement, and fluid within the subacromial-subdeltoid bursa, biceps, and calcific tendinopathy among other findings. Our approach is to have a structured way of examining the shoulder joint, in a stable position as well as during a range of dynamic movements. The tendons and structures are interrogated in transverse and longitudinal planes and images are recorded.
The limited experience of many operators in our environment requires that sonographic protocols are standardized, with emphasis on improved training and the use of advanced imaging techniques like elastography and contrast-enhanced ultrasound, to enhance diagnostic capabilities.
Our review has reinforced the importance of Musculoskeletal ultrasound in identifying major changes such as partial and full tears of the infraspinatus and supraspinatus tendons, impingement, and fluid within the subacromial-subdeltoid bursa, biceps, and calcific tendinopathy, among other findings. Furthermore, the use of standardized protocols by an experienced operator would improve diagnostic confidence and yield.
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