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Publication of the Medical Rehabilitation is under the auspices of the Committee on Rehabilitation, Physical Education and Social Integration of the Polish Academy of Science
Article
Medical Rehabilitation - quarterly journal
Volume 12 year 2008, Issue number 2
Importance of ultrasonographic evaluation in the differentional diagnosis of the shoulder
Authors: Rafał Obuchowicz, Stanisław B. Kita
Medical Rehabilitation 2008; 12(2): 15-23
Importance of ultrasonographic evaluation in the differentional diagnosis of the shoulder
Znaczenie badania ultrasonograficznego w diagnostyce różnicowej barku
Rafał Obuchowicz 1, Stanisław B. Kita 2
1 Ultramedica Medical Center, Cracow, Poland
2 University School of Physical Education In Cracow, Poland
Key words
ultrasonographic examination, shoulder joint, dynamic evaluation
Abstract
The shoulder joint, because of readiness of accessibility of its superficially located soft tissue structures, constitutes an appropriate aim for ultrasonographic examination. Technical progress in the field of ultrasonography and continuously increasing experience of the examiners markedly increased diagnostic usefulness of this imaging modality. Ultrasonographic evaluation, compared to other imaging modalities, outweighs them with its possibility of dynamic examination which gives opportunity of much more accurate evaluation of joint structures while in motion. As a diagnostic method, ultrasonography is also preferred by the patients. The most common cause of pain associated both with degenerative process-induced changes and the posttraumatic shoulder syndrome is supraspinatus muscle tendon tear – ultrasonography enables to identify various types of injury of this and other rotator cuff components. Dynamic evaluation increases diagnostic accuracy in the evaluation of the causes of subacromial impingement including instability of the humeral joint and instability of acromioclavicular joint, pathology of which has recently been situated among the most important causes of shoulder pain. Other pathologic condiction related to extra-skeletal calcifications within the soft tissue structures of the shoulder joint as well as degenerative protrusions from the acromioclavivular joint are readily visualised by means of ultrasonography. Ultrasonographic evaluation is also a recognised method in the assessment of the superficially located tendon of the long head of biceps brachii muscle and it was proven as a very accurate method in the assessment of both chronic and acute biceps tendinitis. It is also considered to be one of the best imaging methods used for detection of the presence of fluid in the gliding spaces and the joint cavity of the shoulder. Depending on experience of the sonographer, ultrasound evaluation should be treated as the imaging study of choice for detection of pathological changes in soft tissues of the shoulder and used as a valuable tool for assessment of different functional pathological states.
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