common shoulder pathologies - bmus · alam, a & shrestha, m (2011) a comparative evaluation of...
TRANSCRIPT
Common Shoulder Pathologies
Normal tendons
Tears
Tendinopathy aka Tendinosis
Bursitis
Bicipital Tenosynovitis
Subacromial Impingement
Other…
https://media1.britannica.com/eb-media/88/182388-004-41CAA735.jpg
http://journal.frontiersin.org/article/10.3389/fbioe.2014.00077/full
http://www.ultrasoundcases.info/Test-Yourself-Case.aspx?test=6500&cat=322&group=68&page=52&show=1
http://www.ultrasoundcases.info/Test-Yourself-Case.aspx?test=6500&cat=322&group=68&page=52&show=1
Median Nerve
Warning! Beware of the subscapularis
https://essr.org/content-essr/uploads/2016/10/shoulder.pdf
Classification:
Partial thickness – involving some of the tendon
Full thickness – basically a hole in part of the tendon; spanning the full depth of the tendon, but does not involve the entire width of the tendon
Complete – involving the entire tendon
Humerus
LS Supraspinatus Tendon Bursal
https://www.google.co.uk/search?q=longitudinal+supraspinatus+tendon&tbm=isch&imgil=__A9l_cpoDqUdM%253A%253B7zYwxZMjap4nTM%253Bhttp%25253A%25252F%25252Fwww.med.umich.edu%25252Fradiology%25252Fmskus%25252Fimages%25252F190%25252F190_sst.html&source=iu&pf=m&fir=__A9l_cpoDqUdM%253A%252C7zYwxZMjap4nTM%252C_&usg=__wvwCYP_X59dhylsQ_X7ZhNkFOF8%3D&biw=1280&bih=623&ved=0ahUKEwim5YnLloPTAhVjFMAKHRvvDM0QyjcIKA&ei=_ZHfWObyHuOogAab3rPoD
A#tbm=isch&q=longitudinal+supraspinatus+tendon+partial+thickness+tear&*&imgrc=MLoVp0grU8c_8M:&spf=558
Humerus
LS Supraspinatus Tendon Articular
http://ultrasoundcases.info/Slide-View.aspx?cat=581&case=6443
Cartilage
Tear
Humerus
LS Supraspinatus Tendon Intratendinous
http://ultrasoundcases.info/Slide-View.aspx?cat=582&case=5120
Humerus
LS Supraspinatus Tendon
http://ultrasoundcases.info/Slide-View.aspx?cat=338&case=7771
Full Thickness
Humerus
LS Supraspinatus Tendon
http://ultrasoundcases.info/Slide-View.aspx?cat=339&case=5406
Complete
http://www.ultrasoundcases.info/Slide-View.aspx?cat=323&case=5012
http://www.med.umich.edu/radiology/mskus/images/190/190_sst.html
Normal
Abnormal
http://321gomd.com/wp-content/uploads/2012/05/biceps-SLAP-Tear.png
Internal tendon degeneration;
An imbalance between tendon break down and repair
In some cases calcium deposits form in damaged tendons, leading to; calcific tendinopathy
http://ultrasoundcases.info/Slide-View.aspx?cat=335&case=6746
22yr old volley ball player
http://ultrasoundcases.info/Slide-View.aspx?cat=336&case=127
Normal
http://ultrasoundcases.info/Slide-View.aspx?cat=327&
http://www.med.umich.edu/radiology/mskus/images/190/190_sst.html
http://www.ultrasoundcases.info/Test-Yourself-Case.aspx?test=7521&cat=322&group=68&page=44&show=1
http://mskultrasoundprocedures.com/Procedures/ShoulderArthrogram.html
http://www.clinicalimagingscience.org/article.asp?issn=2156-7514;year=2012;volume=2;issue=1;spage=38;epage=38;aulast=Gaitini
Normal
Abnormal
http://emedicine.medscape.com/article/401595-overview
When the subacromial structures are compressed between the acromion and humerus during elevation of the arm;
Structural
Functional (Strijcher, D (?) [ONLINE])
http://www.southamptonshoulderclinic.co.uk/shoulder-problems/subacromial-impingement/
https://www.youtube.com/watch?v=w47flKxXD3o
https://essr.org/content-essr/uploads/2016/10/shoulder.pdf
https://www.studyblue.com/notes/note/n/kevin-notes/deck/16293985
http://www.slredultrasound.com/ImageBank/Skeletal.html https://books.google.co.uk/books?id=HnOKCwAAQBAJ&pg=RA4-
PA49&lpg=RA4-PA49&dq=ultrasound+pathological+fracture+humerus&source=bl&ots=CRPHhGhpEN&sig=zlAy9k6IUhNXli6i7fPhP6ehwhc&hl=en&sa=X&ved=0ahUKEwjfqfSCh9bTAhVGORoKHb4LDx0Q6AEIVTAM#v=onepage&q=ultraso
und%20pathological%20fracture%20humerus&f=false
http://ultrasoundcases.info/Slide-View.aspx?cat=451&case=5119
The prevalence of non-symptomatic rotator cuff pathology in the general population varies
Incidence increases with age (Girsh et al, 2011)
Buchbinder et al (2011): 32.24% of 2553 cadavers had a full thickness
rotator cuff tear
It is therefore imperative that ultrasound findings are correlated with the clinical findings and patient history to avoid the over exaggeration of ‘normal for age findings’ which do not require treatment (Girsh
et al, 2011)
Option of comparing with the non
symptomatic side…..
Any Questions?
Alam, A & Shrestha, M (2011) A Comparative Evaluation of Rotator Cuff Injuries of the Shoulder joint Using High Resolution Ultrasound and Magnetic Resonance Imaging. Medical Journal of Shree Birendra Hospital,10(1). June 2011. Pgs 9-14
Al-Ani, Z et al. (2016) Scientific Poster: “The Forgotten Rotator cuff Tendon” – Subscapularis Under the Spotlight. ESSR: www.essr.org. Available: http://webcache.googleusercontent.com/search?q=cache:6G3-Qm9za_UJ:pdf.posterng.netkey.at/download/index.php%3Fmodule%3Dget_pdf_by_id%26poster_id%3D135485+&cd=2&hl=en&ct=clnk&gl=uk
Beggs, I (2011) Shoulder Ultrasound. Seminars in Ultrasound, CT and MRI, 32(2). April 2011. Pgs 101-113
Buchbinder, L et al (2011) Magnetic Resonance Imaging Versus Ultrasonography for Assessing Rotator Cuff Tears in Patients with Shoulder Pain for Whom Surgery is Being Considered (Protocol). The Cochrane Library, 3. Pgs 1-13
Buchbinder, L et al (2011) Magnetic Resonance Imaging Versus Ultrasonography for Assessing Rotator Cuff Tears in Patients with Shoulder Pain for Whom Surgery is Being
Considered (Protocol). The Cochrane Library, 3. Pgs 1-13 Fotiadou, A et al (2008) Ultrasonography of Symptomatic Rotator Cuff Tears
Compared with MR Imaging and Surgery. European Journal of Radiology, 68. Pgs 174-179
Girsh et al,(2011) Ultrasound of the Shoulder: Asymptomatic Findings in Men. American Journal of Roentgenology, 197(4). May 2011. Pgs 713-718
Jacobson, J (2007) Fundamentals of Musculoskeltal Ultrasound. Elsvier Saunder: Philadelphia
Ottenheijm, R et al, (2010) Accuracy of Diagnostic Ultrasound in Patients with Suspected Subacromial Disorders: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation, 91(10). October 2010. Pgs 1616-1625
Replicel™ (2013) Tendons & Tendinosis [online] Available: http://www.replicel.com/tendon-repair/tendons-tendinosis/
Strijcher, D (?) Subacromial Impingement [ONLINE] Available : http://www.physio-pedia.com/Subacromial_Impingement