Extended reports
Ultrasound and operative evaluation of arthritic shoulder joints
a Division of Rheumatology, Department of Internal
Medicine, b Department of
Surgery, c University of Oulu, Finland
Correspondence to: Dr E Alasaarela, Division of Rheumatology, Department of Internal Medicine, University of Oulu, FIN-90220, Oulu, Finland.
Accepted for publication 17 April 1998
OBJECTIVE
To assess the diagnostic value of
ultrasonography (US) in the evaluation of arthritic shoulder joints.
METHODSTwenty shoulders of 20 inpatients with
arthritis were evaluated by US one day before the shoulder operation.
Changes in the subacromial-subdeltoid bursa, biceps tendon and tendon
sheath, rotatof cuff, and glenohumeral joint were recorded and compared with findings at operation.
RESULTSIn the detection of
effusion/hypertrophy in the subacromial-subdeltoid bursa, US had a
sensitivity of 93% and a specificity of 83%. For a biceps tendon
rupture US had a sensitivity of 70% and a specificity of 100%. US
missed three intra-articular biceps tendon ruptures. For
effusion/hypertrophy in the biceps tendon sheath US had a sensitivity
of 100% and a specificity of 83%. For a rotator cuff tear US
had a sensitivity of 83% and a specificity of 57%. US missed two
small longitudinal rotator cuff tears. Three thin membranous, but
intact, rotator cuff tendons were classified as full thickness tears by
US. Synovial effusion/hypertrophy was detected by US and at operation
in all of the 12 glenohumeral joints that were evaluable at surgery.
CONCLUSIONUS is a reliable method in experienced
hands for the evaluation of inflammatory changes of an arthritic
shoulder. In advanced stages of rheumatoid shoulder joints, however, US
is not useful, because destructive bone changes and tendon ruptures
change the normal anatomy and restrict shoulder motions, limiting the
visibility of US.
© 1998 by Annals of the Rheumatic Diseases
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