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谢 雨, 张 强. [Research progress of ultrasound in diagnosis and treatment of shoulder joint diseases]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2024; 38:505-510. [PMID: 38632074 PMCID: PMC11024522 DOI: 10.7507/1002-1892.202312095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/08/2024] [Indexed: 04/19/2024]
Abstract
Objective To review the research progress of ultrasound in the diagnosis and treatment of shoulder diseases, in order to provide a theoretical basis for the further development of ultrasound in shoulder surgery. Methods The recent literature on the application of ultrasound in the shoulder joint was extensively reviewed. The application of ultrasound in the diagnosis and treatment of shoulder joint diseases, and the advantages and disadvantages of ultrasound were analysed, and the development trend of ultrasound technology in the shoulder joint area was prospected. Results At present, the diagnosis of shoulder joint diseases mainly relies on MRI, however, with the development of ultrasound technology, ultrasound with the characteristics of convenient, reliable, and real-time dynamic evaluation is more and more recognized in the diagnosis process of shoulder joint diseases, combined with three-dimensional ultrasound, ultrasound intervention, and elastography can improve the accuracy, sensitivity, and specificity of the diagnosis, and is suitable for the diagnosis and treatment of various shoulder joint diseases, which is expected to carry out early prevention of shoulder joint diseases in the future and achieve more refined and minimally invasive treatment. Conclusion Ultrasound technology has wide application prospect in shoulder joint diseases, but it is still in the developing stage, and the subjective dependence needs to be solved further.
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Affiliation(s)
- 雨欣 谢
- 中国人民解放军医学院(北京 100853)Chinese PLA Medical School, Beijing, 100853, P. R. China
- 中国人民解放军总医院骨科医学部(北京 100853)Department of Orthopedic Surgery, Chinese PLA General Hospital, Beijing, 100853, P. R. China
| | - 强 张
- 中国人民解放军医学院(北京 100853)Chinese PLA Medical School, Beijing, 100853, P. R. China
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2
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Tang R, Li Z, Jiang L, Jiang J, Zhao B, Cui L, Zhou G, Chen X, Jiang D. Development and Clinical Application of Artificial Intelligence Assistant System for Rotator Cuff Ultrasound Scanning. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:251-257. [PMID: 38042717 DOI: 10.1016/j.ultrasmedbio.2023.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/19/2023] [Accepted: 10/24/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE We developed an intelligent assistance system for shoulder ultrasound imaging, incorporating deep-learning algorithms to facilitate standard plane recognition and automatic tissue segmentation of the rotator cuff and its surrounding structures. We evaluated the system's performance using a dedicated data set of rotator cuff ultrasound images to assess its feasibility in clinical practice. METHODS To fulfill the system's primary functions, we designed a standard plane recognition module based on the ResNet50 network and an automatic tissue segmentation module using the Mask R-CNN model. The modules were trained on carefully curated data sets. The standard plane recognition module automatically identifies a specific standard plane based on the ultrasound image characteristics. The automatic tissue segmentation module effectively delineates and segments anatomical structures within the identified standard plane. RESULTS With the use of 59,265 shoulder joint ultrasound images, the standard plane recognition model achieved an impressive recognition accuracy of 94.9% in the test set, with an average precision rate of 96.4%, recall rate of 95.4% and F1 score of 95.9%. The automatic tissue segmentation model, tested on 1886 images, exhibited a commendable average intersection over union value of 96.2%, indicating robustness and accuracy. The model achieved mean intersection over union values exceeding 90.0% for all standard planes, indicating its effectiveness in precisely delineating the anatomical structures. CONCLUSION Our shoulder joint musculoskeletal intelligence system swiftly and accurately identifies standard planes and performs automatic tissue segmentation.
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Affiliation(s)
- Rui Tang
- Department of Ultrasound, Peking University Third Hospital, Beijing, China; Peking University Health Science Center Institute of Medical Technology, Beijing, China
| | - Zhiqiang Li
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Ling Jiang
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Jie Jiang
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Bo Zhao
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing, China.
| | - Guoyi Zhou
- Sonoscape Medical Corporation, Shenzhen, China
| | - Xin Chen
- Sonoscape Medical Corporation, Shenzhen, China
| | - Daimin Jiang
- Sonoscape Medical Corporation(Wuhan), Wuhan, China
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Erber B, Hesse N, Goller S, Reidler P. [Pathologies of the shoulder joint : Anatomy and examination techniques]. RADIOLOGIE (HEIDELBERG, GERMANY) 2024; 64:101-109. [PMID: 38085326 DOI: 10.1007/s00117-023-01246-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 01/27/2024]
Abstract
CLINICAL ISSUE The movements and stability of the human shoulder are a complex dynamic interaction between several joints, muscles and ligaments, which on the one hand enable extensive mobility and on the other hand must provide the necessary stability. Furthermore, the complexity of the shoulder is increased by a large number of normal variants. This article aims to explain the relevant anatomical structures and the radiological examination techniques necessary to visualize them. STANDARD RADIOLOGICAL PROCEDURES Various modalities contribute to the examination of the shoulder. These include X‑rays, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. METHODOLOGICAL INNOVATION It is important to use the various procedures appropriately. Especially with MRI arthrography, it is necessary to pay attention to suitable sequences and possibly additional examination positions. PRACTICAL RECOMMENDATION The multimodal examination of the shoulder can contribute to the diagnosis of numerous clinical pictures. Anatomical and methodological foundations are essential for this.
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Affiliation(s)
- B Erber
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland.
| | - N Hesse
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland
| | - S Goller
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland
- Radiologie, Universitätsklinik Balgrist, Forchstr. 340, 8008, Zürich, Schweiz
| | - P Reidler
- Klinik und Poliklinik für Radiologie, LMU Klinikum, LMU München, Marchioninistr. 15, 81377, München, Deutschland
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Nunna B, Parihar P, Wanjari M, Shetty N, Bora N. High-Resolution Imaging Insights into Shoulder Joint Pain: A Comprehensive Review of Ultrasound and Magnetic Resonance Imaging (MRI). Cureus 2023; 15:e48974. [PMID: 38111406 PMCID: PMC10725840 DOI: 10.7759/cureus.48974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Shoulder joint pain is a complex and prevalent clinical concern affecting individuals across various ages and lifestyles. This review delves into the pivotal role of high-resolution imaging techniques, namely ultrasound and magnetic resonance imaging (MRI), in the comprehensive assessment and management of shoulder joint pain. We explore the anatomical foundations of the shoulder, common etiologies of pain, and the significance of precise diagnosis. High-resolution imaging facilitates the identification of various shoulder pathologies and is crucial in treatment planning, surgical interventions, and long-term prognosis assessment. We examine emerging technologies, discuss challenges and limitations, and chart potential future developments, emphasizing the ongoing evolution of imaging in this critical healthcare domain. In conclusion, high-resolution imaging is an indispensable tool, continually advancing to meet the diagnostic and therapeutic needs of individuals grappling with shoulder joint pain.
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Affiliation(s)
- Bhagyasri Nunna
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pratap Parihar
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Neha Shetty
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Nikita Bora
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Chai JW, Lee JH, Kim DH, Park J, Oh SH, Shin SM. Effect of Patient's Positioning on the Grade of Tendinosis and Visible Range of Infraspinatus Tendon on Ultrasound. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:627-637. [PMID: 37325003 PMCID: PMC10265234 DOI: 10.3348/jksr.2022.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/16/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Purpose To investigate the effect of patient positioning on tendinosis grade, visible range, and infraspinatus tendon (IST) thickness, and to determine the feasibility of internal rotation (IR) position to assess IST on ultrasound (US). Materials and Methods This study included 52 shoulders of 48 subjects who were evaluated for IST in three different positions: neutral position (N), IR, and position with the ipsilateral hand on the contralateral shoulder (HC). Two radiologists retrospectively graded IST tendinosis from grade 0 to grade 3 and the visible range from grade 1 to grade 4. The thickness of the IST was measured by another radiologist with a short-axis view. A generalized estimating equation was used for statistical analysis. Results The tendinosis grades were higher in the HC position than in the IR position, with a cumulative odds ratio of 2.087 (0.004, 95% confidence interval [CI]: 1.268-3.433). The tendinosis grades in the HC position (p = 0.370) and IR position (p = 0.146) were not significantly different from those in the N position. The overall difference in IST thickness was significant (p < 0.001), but the visible range (p = 0.530) was not significantly different according to position. Conclusion Patient positioning significantly affected the grade of tendinosis and thickness but not the visible range of the IST. The IR position is a feasible position for assessing the IST on US.
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Bacha R, Gilani SA, Hanif A, Manzoor I. Subacromial Content to Subacromial Space Ratio in Neutral Position of the Arm as Diagnostic Criteria of Subacromial Impingement Syndrome. J Med Ultrasound 2023; 31:17-21. [PMID: 37180620 PMCID: PMC10173839 DOI: 10.4103/jmu.jmu_195_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/14/2021] [Accepted: 03/02/2022] [Indexed: 05/16/2023] Open
Abstract
Background Shoulder impingement syndrome is one of the main causes of shoulder disability of working-class individuals. Currently, dynamic sonography of the shoulder is the modality of choice for the evaluation of shoulder impingement syndrome. The ratio of subacromial contents (SAC) and subacromial space (SAS) in neutral arm position could be used as a diagnostic parameter for the subacromial impingement syndrome (SIS), especially in patients who have difficulties in the elevation of their shoulders due to pain. To use the SAC to SAS ratio as a sonographic criterion for the diagnosis of SIS. Methods SAC and SAS of 772 shoulders were vertically measured in coronal view with linear transducer 7-14MHz of Toshiba Xario Prime ultrasound unit, while the patient arm was kept in the neutral position. The ratio of both the measurements was calculated, to be used as a diagnostic parameter of the SIS. Results The mean SAS was 10.79 ± 1.94 mm and SAC was 7.65 ± 1.43 mm. SAC-to-SAS ratio for normal shoulders was a focused value with narrow standard deviation (0.66 ± 0.03). However, shoulder impingement is confirmed by any value falls out of the range of ratio for normal shoulders. Area under the curve at 95% confidence interval was 96%, while the sensitivity at 95% confidence interval was 99.25% (97.83%-99.85%), and specificity was 80.86% (76.48%-84.74%). Conclusion SAC-to-SAS ratio in neutral arm position is a relatively more accurate sonographic technique for the diagnosis of SIS.
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Affiliation(s)
- Raham Bacha
- Department (UIRSMIT) FAHS, University of Lahore, Lahore, Pakistan
- Medical Imaging Department, Afro-Asian Institute, Lahore, Pakistan
- Address for correspondence: Dr. Raham Bacha, Gilani Ultrasound Center, Lower Mall, Lahore, Pakistan. E-mail:
| | - Syed Amir Gilani
- Department (UIRSMIT) FAHS, University of Lahore, Lahore, Pakistan
- Medical Imaging Department, Afro-Asian Institute, Lahore, Pakistan
| | - Asif Hanif
- Public Health, University of Lahore, Lahore, Pakistan
| | - Iqra Manzoor
- Medical Imaging Department, Afro-Asian Institute, Lahore, Pakistan
- Public Health, University of Lahore, Lahore, Pakistan
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Nischal N, Iyengar KP, Botchu R. Clicking shoulder due to snapping Subacromial subdeltoid (SASD) bursitis: a case report of an unusual presentation in clinical practice with imaging features. J Ultrasound 2022:10.1007/s40477-022-00758-0. [PMID: 36469227 DOI: 10.1007/s40477-022-00758-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/21/2022] [Indexed: 12/09/2022] Open
Abstract
A spectrum of pathologies can cause clicking, popping or snapping of the shoulder joint. These can lead to a patient seeking attention in clinical practice due to pain, discomfort and impact on activities of daily living. Traditionally these can originate from pathologies which involve biceps tendon, tears of the rotator cuff or the glenoid labrum, articular cartilage or due to loose bodies and scapulothoracic joint dysfunction [Guillin et al. in Br J Radiol 85:1343-1353, 2012; Vidoni et al. in Indian J Musculoskelet Radiol 4:61-69, 2022]. Subacromial subdeltoid (SASD) bursitis is a well-described entity and one of the commonest causes of shoulder pain. We present SASD bursitis as an unusual cause of clicking/snapping in the shoulder without associated pain in a healthy young male. The clinical presentation, diagnostic strategy with complementary imaging and the role of interventional radiology in its effective management is highlighted to support clinicians faced with a diagnostic dilemma.
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Affiliation(s)
- Neha Nischal
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Northfield, Birmingham, UK
| | | | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Northfield, Birmingham, UK.
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The Prevalence of Shoulder Disorders among Professional Bullfighters: A Cross-Sectional Ultrasonography Study. Tomography 2022; 8:1726-1734. [PMID: 35894010 PMCID: PMC9326552 DOI: 10.3390/tomography8040145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate clinical and ultrasound signs of shoulder overuse injuries in professional bullfighters; side-to-side differences (dominant vs. non-dominant); and to determine potential differences according to bullfighters’ categories. An observational cross-sectional study was conducted. Thirty professional and active bullfighters were assessed. A bilateral ultrasound assessment of the subacromial bursa, long biceps head tendon (LHBT), and rotator cuff was performed to determine the presence of bursitis, subluxation, partial or total tendon rupture, tenosynovitis, or calcification. Supraspinatus tendon thickness was measured. Finally, a battery of clinical orthopedic tests (Yergason, Jobe, infraspinatus, Gerber, and bursa tests) were also performed. Most identified ultrasound findings were located in the dominant side, being the presence of bursitis (n = 9; 30%), LHBT tenosynovitis (n = 8; 26.7%), and subscapularis tendon calcification (n = 5; 16.7%) the most prevalent. No side-to-side or between-categories differences were found for supraspinatus tendon thickness (all, p > 0.05). The most frequent positive signs were the infraspinatus test (40.0%), Gerber lift-off test (33.3%), and bursitis, Jobe, and Yergason tests (all, 26.7%). Ultrasound signs were commonly found at LHBT, subacromial bursa, and rotator cuff in professional bullfighters without difference between categories and sides. No side-to-side or between-categories differences were found. Positive clinical test signs suggestive of bursitis, LHBT, and rotator cuff tendinopathy were frequently observed.
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Bacha R, Gilani SA, Hanif A, Manzoor I. Interobserver agreement on the sonographic severity grading of shoulder impingement syndrome. Ultrasound J 2022; 14:22. [PMID: 35648297 PMCID: PMC9160167 DOI: 10.1186/s13089-022-00272-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Shoulder impingement syndrome is the painful entrapment of the soft tissues between the acromion and the humeral head. The severity of shoulder impingement could be graded according to the limitation of shoulder joint moment. The reliability of sonographic findings in the grading of shoulder impingement severity grading is required to be evaluated by the consistency of findings between the observers. PURPOSE To assess the interobserver agreement in the sonographic severity grading of shoulder impingement syndrome with the help of a ratio between acromion-to-greater tuberosity distance in the abduction and neutral arm position. MATERIAL AND METHODS Patients were examined by two independent observers in the coronal approach with neutral arm position. Acromion-to-greater tuberosity distance was measured in abduction and neutral shoulder position. The ratios of the distances in the abduction and neutral position were calculated to grade the severity of shoulder impingement syndrome. RESULTS A total of 78 shoulders were included in this study. A strong agreement was found for the grading of shoulder impingement severity grading between the two independent observers with Kappa value of 0.94. And correlation between the results of the two observers for the severity grading of shoulder impingement syndrome was significant at 0.01 level. CONCLUSION Severity grading of the shoulder impingement syndrome was performed based on the ratio of acromion-to-greater tuberosity distance in abduction and neutral arm position. However, the sonographic findings were consistent and a strong interobserver agreement was seen in this sonographic severity grading.
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Affiliation(s)
- Raham Bacha
- The University of Lahore, Lahore, Pakistan.
- Gilani Ultrasound Center Affroasian Institute Lahore, Lahore, Pakistan.
| | - Syed Amir Gilani
- The University of Lahore, Lahore, Pakistan
- Gilani Ultrasound Center Affroasian Institute Lahore, Lahore, Pakistan
| | - Asif Hanif
- The University of Lahore, Lahore, Pakistan
- Gilani Ultrasound Center Affroasian Institute Lahore, Lahore, Pakistan
| | - Iqra Manzoor
- The University of Lahore, Lahore, Pakistan
- Gilani Ultrasound Center Affroasian Institute Lahore, Lahore, Pakistan
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Ricci V, Chang KV, Güvener O, Mezian K, Kara M, Leblebicioğlu G, Stecco C, Pirri C, Ata AM, Dughbaj M, Jain NB, Özçakar L. EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Shoulder. Am J Phys Med Rehabil 2022; 101:e29-e36. [PMID: 34923500 DOI: 10.1097/phm.0000000000001833] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT In this dynamic protocol, ultrasound examination of the shoulder using different maneuvers is described for several/relevant shoulder problems. Scanning videos are coupled with real-time patient examination videos for better understanding. The authors believe that this practical guide prepared by an international consensus of several experts (EURO-MUSCULUS: European Musculoskeletal Ultrasound Study Group and USPRM: Ultrasound Study Group of ISPRM [International Society of Physical and Rehabilitation Medicine]) will help musculoskeletal physicians perform a better and uniform/standard approach.
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Affiliation(s)
- Vincenzo Ricci
- From the Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, A.S.S.T. Fatebenefratelli-Sacco, Milan, Italy (VR); Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei City, Taiwan (K-VC); National Taiwan University College of Medicine, Taipei, Taiwan (K-VC); Department of Physical and Rehabilitation Medicine, Mersin University Medical School, Mersin, Turkey (OG); Department of Rehabilitation Medicine, Charles University, First Faculty of Medicine, Prague, Czech Republic (KM); Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, LÖ); Hand Surgery Unit, Department of Orthopaedics and Traumatology, Hacettepe University Medical School, Ankara, Turkey (GL); Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy (CS, CP); Department of Physical Medicine and Rehabilitation, Doctor Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey (AMA); Physical Medicine and Rehabilitation Hospital, Ministry of Health, Kuwait City, Kuwait (MD); and Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Population and Data Sciences, University of Texas Southwestern, Dallas, Texas (NBJ)
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Firnberg MT, Rabiner JE. Point-of-Care Ultrasound of a Shoulder Effusion in a Child With Septic Arthritis: A Case Report. Pediatr Emerg Care 2022; 38:e1025-e1027. [PMID: 34140449 DOI: 10.1097/pec.0000000000002465] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Point-of-care musculoskeletal ultrasound can facilitate diagnosis of joint effusions and help guide management of suspected septic joints. This case report describes a previously healthy pediatric patient with acute onset shoulder pain and fever who was found to have leukocytosis and bacteremia. Point-of-care ultrasound (POCUS) demonstrated a unilateral shoulder joint effusion. After POCUS was performed, purulent fluid was aspirated from the joint, and she was diagnosed with a septic shoulder. We review the ultrasound technique, sonographic findings, and literature regarding POCUS for shoulder effusions.
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Affiliation(s)
- Maytal T Firnberg
- From the Department of Emergency Medicine, Division of Pediatric Emergency Medicine, New York-Presbyterian Morgan Stanley Children's Hospital/Columbia University Irving Medical Center, New York, NY
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Miyake S, Tamai M, Takeuchi Y, Izaki T, Arashiro Y, Shibata Y, Shibata T, Yamamoto T. Alteration of coracoacromial ligament thickness at the acromial undersurface in patients with rotator cuff tears. JSES Int 2022; 6:468-472. [PMID: 35572436 PMCID: PMC9091775 DOI: 10.1016/j.jseint.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Some researchers have stated that magnetic resonance imaging (MRI) is useful for assessing the coracoacromial ligament (CAL) at the acromial undersurface. However, few studies have investigated the reliability and clinical significance of MRI findings for the CAL at the acromial undersurface. The purpose of this study was to determine the association between CAL thickness at the acromial undersurface and rotator cuff tear size. Methods The CAL thickness at the acromial undersurface was evaluated in 182 patients with rotator cuff tears (mean age: 64.9 ± 8.4 years) using a 3.0-Tesla MRI system. The association between CAL thickness at the acromial undersurface and rotator cuff tear size determined by the DeOrio and Cofield classification (partial; small: <1 cm; medium: 1-3 cm; and large or massive: >3 cm) was analyzed statistically. The intraobserver and interobserver reliabilities for MRI measurements of CAL thickness at the acromial undersurface were determined by calculation of intraclass correlation coefficients and their 95% confidence intervals. Results The mean CAL thickness at the acromial undersurface was 2.7 ± 1.4 mm (range: 0-6.5 mm). Increasing rotator cuff tear size was significantly associated with decreasing CAL thickness at the acromial undersurface (P = .004). The intraobserver and interobserver intraclass correlation coefficients for CAL thickness at the acromial undersurface were almost perfect (0.98 and 0.91, respectively). Conclusion The present study clarified that (1) MRI was a reliable tool for evaluation of CAL thickness at the acromial undersurface and (2) increasing rotator cuff tear size was significantly associated with decreasing CAL thickness at the acromial undersurface. These findings may assist toward understanding the progressive pathology in rotator cuff disease.
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Abstract
In this article the basic principles of fracture sonography and meaningful areas of application in children and adults are explained. The sonographic fracture signs are presented and the typical areas of application, i.e. clavicular fracture, acromioclavicular (AC) joint dislocation, proximal humerus fracture, elbow fracture, wrist fracture, metacarpal 5 fracture, palmar plate, femoral bulge fracture, proximal tibia fracture, midfoot V fracture, toddler's fracture and march fracture, are outlined and known diagnostic algorithms are listed. When used correctly, fracture sonography is a safe, gentle and rapid diagnostic method.
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Affiliation(s)
- Ole Ackermann
- Orthopädie Ackermann, Raiffeisenstr. 58-60, 47259, Duisburg, Deutschland.
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14
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Gala-Alarcón P, Prieto-Gómez V, Bailón-Cerezo J, Yuste-Sánchez MJ, Arranz-Martín B, Torres-Lacomba M. Changes in shoulder outcomes using ultrasonographic assessment of breast cancer survivors: a prospective longitudinal study with 6-month follow-up. Sci Rep 2021; 11:23016. [PMID: 34837018 PMCID: PMC8626448 DOI: 10.1038/s41598-021-02379-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/15/2021] [Indexed: 11/08/2022] Open
Abstract
This study aimed to describe changes in supraspinatus tendon thickness, acromiohumeral distance, and the presence of fluid in the subacromial bursa as measured by ultrasound, as well as shoulder range of motion and strength, perceived shoulder disability, and health-related quality of life in women before and after breast cancer treatment. Women who underwent surgery for unilateral breast cancer who did not suffer from shoulder pain or difficulty performing activities of daily living in the 6 months prior to surgery were included. One pre-surgical (A0) and three post-surgical assessments at 7-10 days (A1), 3 months (A2), and 6 months (A3) after surgery were carried out. The thickness of the supraspinatus tendon on the affected side decreased between post-surgical (A1) and 6-month (A3) follow-up assessments (p = 0.029), although the minimal detectable change was not reached. The active range of motion of the affected shoulder decreased after surgery. Strength changes were observed in both shoulders after surgery. The intensity of shoulder pain increased between post-surgical and 6-month follow-up assessments. Shoulder function was decreased at the post-surgical assessment and increased throughout the follow-ups. Health-related quality of life declined after surgery. A trend of decreasing thickness of the supraspinatus tendon of the affected shoulder was observed. Detecting these possible structural changes early would allow for early or preventive treatment.
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Affiliation(s)
- Paula Gala-Alarcón
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
| | - Virginia Prieto-Gómez
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
| | - Javier Bailón-Cerezo
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
| | - María José Yuste-Sánchez
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
| | - Beatriz Arranz-Martín
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain.
| | - María Torres-Lacomba
- Physiotherapy in Women's Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805, Madrid, Spain
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15
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Babaei-Ghazani A, Boudier-Revéret M, Michaud J. Zebras in the Shoulder: a Review Article on Advanced Diagnostic Ultrasound of the Shoulder. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00331-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Bruns A, Möller I, Martinoli C. Back to the roots of rheumatology - Imaging of regional pain syndromes. Best Pract Res Clin Rheumatol 2020; 34:101630. [PMID: 33272828 DOI: 10.1016/j.berh.2020.101630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Musculoskeletal regional pain syndromes (RPS) often lead to patient referrals in general and rheumatological practice. Detailed history taking and clinical examination can, in most cases, reveal the cause for pain and direct the subsequent management of the conditions. Yet, when in doubt, imaging methods, such as ultrasound (US) may support the clinical assessment. This paper reviews the underlying pathologies of some of the most frequently encountered RPS and the role of musculoskeletal US imaging for their diagnosis and treatment. If available, data on diagnostic accuracy and comparisons with gold standards are reported. The article stresses the importance of anatomical and sonoanatomical knowledge for the proper interpretation of the US images, points out the advantages and disadvantages of this imaging tool, and suggests the future research agenda.
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Affiliation(s)
- Alessandra Bruns
- Division of Rheumatology, Sherbrooke University, Sherbrooke, Canada.
| | - Ingrid Möller
- Instituto Poal de Reumatologia, University of Barcelona, Barcelona, Spain
| | - Carlo Martinoli
- Department of Health Sciences (DISSAL), Università di Genova, Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
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17
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Patel SJ, Singh JA, Epstein MH, Jayaram P. Dynamic Ultrasound Uniquely Reveals Anterior Capsular Tear Communicating With Vastus Intermedius Fibers. Cureus 2020; 12:e8880. [PMID: 32742847 PMCID: PMC7388733 DOI: 10.7759/cureus.8880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We present a case of an anterior capsular tear of the right knee in a previously healthy, active individual. The patient was a 31-year-old male seen one month after the onset of throbbing anterior right knee pain, which progressed to sharp suprapatellar pain over the next three months. Both dynamic ultrasound (US) and MRI were obtained. Dynamic US revealed a tear of the anterior capsule of the right knee complicated by a suprapatellar effusion communicating into the vastus intermedius fibers of the quadriceps tendon. However, these findings were not evident on MRI. In addition to discussing this unique pathology, we highlight the utility of both standard and dynamic US in establishing diagnoses for capsular pathologies.
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Affiliation(s)
- Shiv J Patel
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, USA.,Joseph Barnhart Department of Orthopedic Surgery, Baylor College of Medicine, Houston, USA
| | - Jasvinder A Singh
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, USA
| | - Max H Epstein
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, USA
| | - Prathap Jayaram
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, USA
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18
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Zheng F, Wang H, Gong H, Fan H, Zhang K, Du L. Role of Ultrasound in the Detection of Rotator-Cuff Syndrome: An Observational Study. Med Sci Monit 2019; 25:5856-5863. [PMID: 31386649 PMCID: PMC6693366 DOI: 10.12659/msm.915547] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Physical tests are usually preferred to assess rotator-cuff syndrome but are insufficient to predict the morphology and size of the rotator-cuff. The objective of the study was to rate the ultrasound findings for patients with sudden shoulder pain and to determine potential predictors of the same. Material/Methods A total of 112 patients with sudden shoulder pain with rotator-cuff syndrome, suspected by orthopedic doctors, were subjected to ultrasonography. Real-time ultrasonography was done for the acromioclavicular joint, biceps, infraspinatus, posterior labrum, subscapularis, supraspinatus, teres minor tendon, and the sub-acromial-subdeltoid bursa. Each tendon was assessed via scanning planes in orientation as per longer and shorter axis, and from their myotendinous junction shoulder to bony insertions. Linear and logistic regression analysis were performed to predict the associations of medical history with rotator-cuff injury. Results Ultrasonography identified that 82% of the enrolled patients had at least one particular cause of the rotator-cuff disorder. Among the rotator-cuff disorders, calcific tendonitis (54%) was observed more frequently followed by tendinopathy (32%), subacromial-subdeltoid bursitis (22%), and partial thickness tear (21%). Also, 46 patients (41%) had multiple findings. Older age (older than 40 years) was a strong predicting factor of rotator-cuff disorder (r2=0.36, P=0.0004). Conclusions Ultrasonography is a vital diagnostic procedure used by orthopedic surgeons for diagnosis of the rotator-cuff disorder(s) in patients with sudden shoulder pain.
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Affiliation(s)
- Fang Zheng
- Shanghai General Hospital of Nanjing Medical University, Shanghai, China (mainland).,Department of Ultrasonic, The First Affiliated Hospital of XinXiang Medical University, Weihui, Henan, China (mainland)
| | - Haiyan Wang
- Department of Ultrasonic, The First Affiliated Hospital of XinXiang Medical University, Weihui, Henan, China (mainland)
| | - Hongyan Gong
- Department of Anesthesiology, The First Affiliated Hospital of XinXiang Medical University, Weihui, Henan, China (mainland)
| | - Huijun Fan
- Department of Ultrasonic, The First Affiliated Hospital of XinXiang Medical University, Weihui, Henan, China (mainland)
| | - Kai Zhang
- Department of Ultrasonic, The First Affiliated Hospital of XinXiang Medical University, Weihui, Henan, China (mainland)
| | - Lianfang Du
- Shanghai General Hospital of Nanjing Medical University, Shanghai, China (mainland)
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19
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Ultrasound Visualization of Torsional Anatomic Changes From External Rotation of the Anterior Shoulder. J Comput Assist Tomogr 2019; 43:519-523. [DOI: 10.1097/rct.0000000000000861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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