US finding of the shoulder (with live demonstration) 인제의대상계백병원 안재기
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1 US finding of the shoulder (with live demonstration) 인제의대상계백병원 안재기
2 Shoulder US Biceps tendon & Rotator Cuff Long Head of Biceps Tendon Subscapularis tendon Supraspinatus tendon Infraspinatus tendon Teres minor tendon Acromioclavicular joint Glenoid labrum SASD Bursa
3
4 Surface anatomy Greater tuberosity Lesser tuberosity Acromion Clavicle AC joint Scapular spine Bicipital groove Coracoid Surpaspinatus tendon Infraspinatus tendon Subscapularis tendon
5 Biceps, transverse scan
6 Biceps, longitudinal scan
7 Anisotropic reflectors Transverse sonogram shows normal long head of biceps tendon
8 Effusion in the biceps tendon sheath
9 Effusion in the biceps tendon sheath in adhesive capsulitis
10 Biceps tendinitis Lesion wnl Lesion wnl longitudinal transverse
11 Power Doppler Biceps tenosynovitis
12
13 Subscapularis, longitudinal scan
14 Subscapularis partial tear
15 Supraspinatus, transverse scan
16 Supraspinatus, longitudinal scan
17 Normal supraspinatus tendon
18 Calcific tendinitis of supraspinatus longitudinal transverse
19 Acoustic shadowing longitudinal transverse Longitudinal and transverse US scans of a calcium (Ca) deposit in a rotator cuff (supraspinatus tendon)
20 transverse longitudinal
21 Rotator cuff tear Partial thickness tear Bursal surface tears Intrasubstance tears Articular surface tears (~90% of partial tear) Full-thickness tear (communication between the GH joint and the SASD bursa) small (1cm), medium (2-3cm), large (3-5cm), massive (>5cm) In larger tears, chronically retracted muscles undergo fatty degeneration over time that may be irreversible
22 SST, Bursal surface tear
23 SST, Intrasubstance tear longitudinal transverse
24 SST, Articular surface tear longitudinal transverse
25 Partial thickness tear of supraspinatus longitudinal transverse
26 Secondary signs Full-thickness tears Cortical irregularity of the greater tuberosity Subacromial-subdeltoid bursitis Cartilage sign Effusion in the biceps tendon sheath Glenohumeral joint effusion
27 Full-thickness tear of supraspinatus longitudinal transverse
28 Secondary signs of full-thickness rotator cuff tear Cortical irregularity of tuberosity Volume loss, subacromial-subdeltoid bursa contour deformity, flattening,
29 Herniation of the deltoid muscle longitudinal transverse
30 Hypoechoic or anechoic cleft in the cuff transverse
31 Chronic massive tear of supraspinatus longitudinal transverse Absence of rotator cuff Atrophy of greater tuberosity
32 Massive tear of supraspinatus
33 Probe compression
34 Massive tear of supraspinatus Deltoid cartilage interface (cartilage sign) Probe compression
35 Infraspinatus, transverse scan Humeral head
36 Infraspinatus, longitudinal scan
37 Acromioclavicular joint
38 Acromioclavicular joint 1. Lax capsule, AC ligament(superior, inferior, anterior, posterior) 2. Intraarticular disc, fibrocartilage disc 3. Concave acromion, convex distal clavicle
39 AC joint, arthritis
40 Rupture of AC joint longitudinal WNL
41 Subdeltoid bursa
42 Bursae around the shoulder joint Subacromial-subdeltoid bursa Subscapularis bursa Subcoracoid bursa Coracoclavicular bursa Supraacromial bursa
43 Subdeltoid bursitis
44 Subdeltoid bursitis
45 Fluid collection & SASD bursitis longitudinal transverse
46 Subacrmomial-Subdetoid bursitis
47 Subacrmomial-Subdetoid bursitis
48 Subacrmomial-Subdetoid bursitis longitudinal transverse
49 Fracture, greater tuberosity after trauma longitudinal transverse cortical disruption of greater tuberosity(arrows) at supraspinatus insertion
50 Fracture, Greater Tuberosity
51 Hill-Sachs lesion
52 Thanks for your attention!!
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