More Related Content Similar to Ultrasound - Shoulder (20) More from Alan M. Hirahara, M.D., FRCSC (20) Ultrasound - Shoulder1. Ultrasound of the Shoulder
Alan M. Hirahara, M.D., FRCS(C)
Board Certified in Orthopaedic Surgery & Orthopaedic Sports Medicine
Specializing in arthroscopic shoulder surgery
Medical Director Team Physician Consultant
Sacramento State Athletics Sacramento River Cats Oakland A’s
MiLB - AAA
3. Diagnostic Uses
• Soft tissue disorders • Joint disorders
– Tears – Erosions on bones
• Muscle, tendon, ligament – Loose bodies
– Inflammation – Pannus
• Plantar fasciitis, tenosynovitis – Inflammation
– Masses – Effusion
• Hematoma, cyst, solid tumors, calcific
tendonitis
– Nerve disorders • Bone disorders
• Morton’s neuroma, neuropathies, – Fractures
trauma
– Stress fractures
– Foreign bodies
– Infections
4. Therapeutic Uses
• Injections • Biopsy
– Marcaine/Lidocaine • Removal of foreign bodies
– Cortisone
– Hyaluronic acid
– PRP
• Aspiration
– Drain joints
– Drain hematomas
• Surgical adjunct to arthroscopy
10. Ultrasound Technique: Shoulder
• Biceps tendon
– Longitudinal & Transverse
– Superior & Inferior
• Subscapularis
• Infraspinatous
– Longitudinal & Transverse
– Longitudinal & Transverse
• Coracoid - Subscapularis
• Glenohumeral jt & Labrum
– Subcoracoid impingement
• AC joint
• Supraspinatous
– Longitudinal & Transverse
– Anterior & Posterior
– Subacromial bursa
11. Biceps Tendon - Transverse
• Arm position: Neutral
• Tip: Find bicipital groove
• MRI equivalent: Axial plane
12. Biceps Tendon – Trans / Sup vs Inf
• Superior: Deep bicipital groove
• Inferior: Flattened bone with transition to muscle
16. Biceps Tendon - Longitudinal
• Arm position: Neutral
• Tip: Find transverse view, keep groove centered then turn probe 90o
• MRI equivalent: Sagittal plane
19. Subscapularis - Transverse
• Arm position: External rotation
• Tip: Find longitudinal view, then turn probe 90o
• MRI equivalent: Sagittal plane
25. Supraspinatous - Longitudinal
• Arm position: Extended
• Tip: Probe parallel plane [Contralateral shoulder : Ipsilateral hip]
• MRI equivalent: Coronal plane
26. Supraspin. – Long / Ant vs Post
• Anterior: Step off pronounced on tuberosity
• Posterior: Flatter transition of head to tuberosity
28. Supraspinatous - Transverse
• Arm position: Extended
• Tip: Probe parallel plane [Ipsilateral shoulder : Contralateral hip]
• MRI equivalent: Sagittal plane
29. Supraspin. – Trans / Ant vs Post
• Anterior: Note biceps tendon
• Posterior: See black cartilage layer over bone
37. Infraspinatous - Transverse
• Arm position: Neutral to flexed
• Tip: Find longitudinal view, then turn probe 90o
• MRI equivalent: Sagittal plane
39. Glenohumeral Joint
• Arm position: Neutral
• Tip: Find longitudinal view infraspinatous, then move medial, rotating arm
• MRI equivalent: Axial plane
42. AC Joint
• Arm position: Neutral
• MRI equivalent: Coronal plane
• Tip: Palpate the joint for easy localization
Editor's Notes Volk, Betty Leveille, David Fuller, Brian StClair, Donald Barranza, Ramualdo Montes-Osorio, Benjamin Gross, Randolph Amaya, Ruben Amaya, Ruben Vincent, Jerry Koslucher, Jon Kurtzpuga, Janet Mortensen, Darcy Galia, Veronica Parsons, Jean Basmajian,Adam Nava, Jorge Schuller, Matthew Barrick, Bethany