Ultrasound of the shoulder
Section snippets
History
Shoulder ultrasound has been performed for approximately 20 years, with the first literature report in 1979 (Seltzer et al., 1979). Subsequently the technique has been developed to improve visualisation of the rotator cuff (Crass et al., 1984). However, the major advances have been technological. Substantial improvements in hardware have occurred especially in small parts high resolution probes. Initially poor results were reported for US in comparison to arthrography, but these studies are now
Anatomy
The rotator cuff includes four muscles.
The supraspinatus spans between the posterior aspect of the scapula, above the scapular spine (supraspinatus fossa) to insert on the upper facet of the greater tuberosity. The subacromial bursa separates it from the acromium, the deltoid and the coraco-acromial ligament.
Below this is the infraspinatus, which crosses from the infraspinous scapular fossa to the middle facet of the greater tuberosity. It is separated from the scapula by a bursa.
More inferior
Technique
The authors examine the shoulder from behind the patient, which in their view allows for an increased stability in scanning and therefore less hand fatigue for the operator (Middleton, 1992), but some sonographers would rather examine from the front of the patient. A technique for scanning with the patient supine and the arm hung down by the side has also been described (Turrin and Cappello, 1997). When examining the seated patient they should be on a backless stool at a height that is
Rotator cuff tears
The detection or exclusion of rotator cuff tears is the most common reason for using ultrasound to examine the shoulder and in experienced hands it can be relied upon to make surgical decisions (Wiener and Seitz, 1993). With the advent of arthroscopic rotator cuff repairs ultrasound has become an important means of detecting small tears, with small tears less than 5 mm (or arguably10 mm) being amenable to arthroscopic repair. It is agreed that in experienced hands the detection of such tears
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2022, Sensors and Actuators A: PhysicalQuantitative Evaluation of Rotator Cuff Tears Based on Non-linear Statistical Analysis of Ultrasound Radiofrequency Signals
2021, Ultrasound in Medicine and BiologyCitation Excerpt :US is an alternative imaging method for dynamic and functional assessment of RCTs. Compared with MRI, US is less costly and has few contraindications for most patients (Allen and Wilson 2001; Vlychou et al. 2009; Kim et al. 2017; Chang et al. 2020; Chiu et al. 2020). It has been reported that the diagnostic accuracy of US is comparable to that of MRI for full-thickness RCTs (Teefey et al. 2000; Roberts et al. 2001; Miller et al. 2008), while it may be reduced in the diagnosis of partial-thickness RCTs because experience may differ between operators (Martin-Hervas et al. 2001; Teefey et al. 2004; Moosmayer et al. 2007; Vlychou et al. 2009; Sipola et al. 2010; Smith et al. 2011; Okoroha et al. 2019).
Ultrasonographic Evaluation and Feasibility of Posterosuperior Internal Impingement Syndrome: A Case Series
2017, PM and RCitation Excerpt :The gold-standard test for deep shoulder structures such as the labrum, bone lesion, and ligamentous abnormalities is MRI, which can be expensive and inaccessible [5]. Interestingly, we found that US had advantages over MRI for PSI syndrome, although US for these peri-articular structures, including labrum and bony cyst, is generally limited [4-6]. First, MRI did not identify the rotator cuff partial-thickness tears in the posterior supraspinatus or upper infraspinatus areas as cardinal PSI lesions in patients 2 and 3.
Computer-Aided Diagnosis of Different Rotator Cuff Lesions Using Shoulder Musculoskeletal Ultrasound
2016, Ultrasound in Medicine and BiologyCitation Excerpt :However, large foci of hard calcification appear as hyper-echoic convex contours with acoustic shadows (Beggs 2011). Supraspinatus tears are characterized by hypo-echoic areas with irregular margins (Allen and Wilson 2001; Kurol et al. 1991; Vlychou et al. 2009). According to tissue characteristics reported in prior studies, the morphologic features widely used in CAD systems may not be useful in lesion classification because there is no rule of shape description for a specific lesion type.
Accuracy of diagnostic ultrasound in patients with suspected subacromial disorders: A systematic review and meta-analysis
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