Shoulder Ultrasonography

Shoulder Ultrasonography


Shoulder US'i, using high-frequency linear probes noninvasive, real-time method for a radiographic examination. Between 7 and 12 MHz frequency can be changed according to the examined tissue. Soft tissue and vascular structures to determine changes in hyperemic CDUS and power Doppler is useful. Ultrasonography of the shoulder with the shoulder region of skin, subcutaneous tissues, subacromial bursa, rotator cuff tendons, glenohumeral joint, bone contours, deltoid and long head tendon bisepsin information available about. In the literature on the sensitivity and specificity of sonography in the various figures given as a general consensus on the use of shoulder pathologies in the first survey are available. Reliability and sensitivity are very high by experienced radiologists.


U.S. examination of the shoulder is seated on a stool returns to the patient. This position will sonographers person's shoulder to reach from all directions with ease. In order to sonography in shoulder, shoulder, very good knowledge of topographic anatomy is essential. Orientation of the probe is made ​​according to the orientation of the tendons.


Evaluation of the long head tendon of biceps muscle


The patient is placed in neutral position, the elbow angle is 90 ° and the hand propping up the string section of the dorsal and axial probe placed on the proximal humerus, long tendon of biceps groove bisipital between large and small tubercle-per-axial and sagittal planes is shown.


Long head of biceps muscle and tendon as bisipital oval hyperechoic sonographic appearance of the gutter and the schematic axial cross-section, cadaver, and Magnetic Resonance Imaging (MRI) shows the correlation between views


Turned 90 ° in the sagittal plane perpendicular to the axial plan Probe biceps tendon fibers are shown.


Evaluation of subscapular tendon


Brought to 90 ° flexion of the elbow and arm external rotation. The probe according to the localization of the biceps tendon sliding mild medial tubercle subscapular tendon adhesion to the small lot is shown along with the long axis


Evaluation of supraspinatus tendon


And internal rotation of the arm is brought. Large tubercle anterior to the sagittal plane shoulder tendon is taken as a cue point long axis. The long axis of the attachment point is in the style of the bird's beak


Examination of the long axis short axis is rotated 90 ° clockwise after the probe is considered


Tendon Pathologies detected by ultrasonography


An ultrasound torn tendons, tenosynovitis, bursitis and calcific tendinitis, subacromial-subdeltoid determined.


Torn: the deterioration of the integrity of the tendon. Full-thickness articular surface or articular face to face with is called limited if the partial tear.


Tendinosis: tendon degeneration without inflammation. But it is difficult to detect radiographically detectable with U.S.. Tendon thickening and heterogeneity are seen.


Tenosynovitis: Inflammation of the tendon sheath effusion was observed around the tendon. Especially seen around the biceps tendon.


Sub-deltoid subacromial bursitis: inflammation secondary collection of fluid.


Calcific tendonitis: tendon is seen as a result of the accumulation of calcium. Linear hyper-echoic in U.S. and posterior acoustic shadowing can be seen while the RDUS'de hyperemia.