Faroes Lectures 2019

1. Point-of-care Ultrasound of the
shoulder
What you get is what you see – and there is
nothing more to it…..
Tina Turner
Dr. Bjørn Skjoldbye; Dept. of Radiology; Aleris Hamlet Private Hospitals, Copenhagen, Denmark

2. Point of Care Ultrasound of the shoulder
• Recognize normal anatomy/abnormal findings of
– The Rotator Cuff (tear +/-) (egality +/-)
– The Biceps longus tendon (tear +/-) (egality +/-)
– GLH hydarthon (+/-)
– Subacromeal/subdeltoid bursa (+/- fluid)
– AC joint (artritis +/-) (egality +/-)
– US guided bloc/inj.
– Solid and cystic leasions

6. Short Operating Manual US
• ID
• Transducer selection
• Application
• Activate/Freeze
• Size
• Focus
• Frequency
• Gain (TGC)
• Single/Dual (compare)
• Freeze/Activate
• Text - measure
• Store clip or image
End
Start

7. Dual image side-by-side evaluation
SST Rt SST Lt

8. Transverse and longitudinal presentation

9. Dynamic evaluation. Storage of a clip

10. Infraspinatus Lesion

11. Lower gain

12. Higher gain

13. Longitudinal
ANISOTROPY

15. Bursae in the shoulder

16. Subdeltoid bursitis

17. Bicep longus tendon
Peritendinous fluid

18. Bicep longus

19. Bicep longus

21. MED
Subluxation
of the Long Head of the Biceps

22. sst
bursa

23. SST Impingement

24. Calcified supraspinatus tendinitis

26. Gleno-humeral joint
Posterior labrum

27. AC Artritis

28. Infraspinatus rupture

29. Subscapularis lesion

30. Subscapularis tear

31. Principles of Interventional US
• Diagnostic
• Therapeutic
• Puncture
– Biopsy
– Aspiration
– Drainage
– Ablation
– Injection

32. In-Plane Out-of-plane

33. In-plane US-Guided injection

34. Ultrasound can´t scan it all !

35. US-guided artrocentesis
for contrast enhanced MR

36. Right shoulder artrocentesis

37. Right shoulder artrocentesis

38. Left shoulder artro

39. Left shoulder artro

40. Left shoulder artro

41. Subcutaneous lipoma

42. Solid intramuscular mass

43. Subcapsular fluid collection

44. Dynamic evaluation of intra-muscular mass

45. Ganglion; Perichondral cyst