Ultrasonographic diagnostic criteria of shoulder abnormalities
Shoulder abnormality | Diagnostic criteria |
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Biceps sheath effusion | Thickness of the hypoechoic halo of fluid surrounding the biceps tendon greater than 2 mm |
Biceps tendinitis | Increased fluid within the synovial sheath and tendon hypoechogenicity and/or thickening |
Biceps tendon rupture | Partial or complete interruption of the tendon fibres, separation of the ends and hypoechoic fluid filling the defect |
Biceps tendon subluxation | Empty bicipital groove and identification of the displaced tendon |
Biceps tendon degeneration | Tendon hypoechogenicity and tendon thinning |
Rotator cuff tendinitis | Tendon hypoechogenicity or tendon thickening with or without internal hypo or hyperechoic foci |
Subscapularis full thickness tear | Non-visualisation of tendon or complete fibres discontinuity |
Subscapularis partial thickness tear | Partial fibre discontinuity |
Supraspinatus and infraspinatus full thickness tear | Non-visualisation of tendon or fibre discontinuity from the humeral head to the subacromial-subdeltoid bursa or superior convexity instead of concavity |
Supraspinatus and infraspinatus partial thickness tear | Hypoechoic fibre discontinuity involving the bursal or articular surface or intrasubstance hypoechoic defect or focal tendon thinning |
Subacromial-subdeltoid bursitis | Hypoechoic fluid filled bursa greater than 2 mm thick |
Acromioclavicular degenerative changes | Cortical irregularities or osteophytes, usually acompanied by intra-articular hypoechoic fluid displacing joint capsule |
Glenohumeral effusion | Distance from the posterior labrum to the posterior infraspinatus tendon greater than 2 mm |
Rotator cuff calcifications | Hyperreflective foci or lines with acoustic shadowing |
Rotator cuff impingement | A buckling of the cuff/rippling effect as the cuff passes beneath the coracoacromial arch or fluid distending the subacromial-subdeltoid bursa or thickened bursa in front of the acromion while the arm is abducted |