Detection and Measurement of Rotator Cuff Tears with Sonography: Analysis of Diagnostic Errors
|
|
- Job Phelps
- 6 years ago
- Views:
Transcription
1 Musculoskeletal Imaging Teefey et al. Detection of Rotator Cuff Tears with Sonography Sharlene A. Teefey 1 William D. Middleton 1 William T. Payne 2 Ken Yamaguchi 3 Teefey SA, Middleton WD, Payne WT, Yamaguchi K Received July 30, 2004; accepted after revision September 15, Supported by a grant from Society of Radiologists in Ultrasound. 1 Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd., St. Louis, MO Address correspondence to S. A. Teefey (teefeys@mir.wustl.edu). 2 Department of Orthopaedics and Rehabilitation, Southern Illinois University School of Medicine, Springfield, IL Department of Orthopaedic Surgery, One Barnes-Jewish Hospital Plaza, St. Louis, MO AJR 2005;184: X/05/ American Roentgen Ray Society Detection and Measurement of Rotator Cuff Tears with Sonography: Analysis of Diagnostic Errors OBJECTIVE. The purpose of this study was to analyze the causes of errors in the detection and measurement of rotator cuff tears in our patient population. SUBJECTS AND METHODS. Seventy-one consecutive patients with shoulder pain who were prospectively studied with sonography had subsequent arthroscopy that showed a full-thickness or partial-thickness tear or intact cuff. For sonography and arthroscopy, the length or degree of retraction and width of a tear, when present, was recorded. When there were discrepant findings, representative images were jointly evaluated by the radiologist and orthopedic surgeon to determine the cause of the error. RESULTS. Fifteen detection errors were found, including five misses (three < 5-mm subscapularis and two small partial-thickness tears), four errors inherent with the test (distinguishing large bursal side or extensive partial-thickness from full-thickness tears and tendinopathy from partial-thickness tears), three errors of an unknown cause, two due to misinterpretation, and one error inherent with the patient. Seventeen measurement errors occurred with full-thickness tears, 15 of those in patients with large or massive tears. Bursal thickening (n = 4), nonvisualization of the torn tendon end (n = 2), nonretracted tear (n = 2), and complex tear (n = 1) contributed to the errors. Eight measurement errors occurred with partial-thickness tears. Difficulty distinguishing tendinopathy from partial-thickness tears (n = 3) and complex tears (n = 3) accounted for six errors. CONCLUSION. Although infrequent, detection errors were due to limitations inherent with the test or misses. Limitations inherent with the patient and misinterpretation of the findings were rare. Most measurement errors occurred in patients with large or massive cuff tears. otator cuff disease is the most R common cause of shoulder pain. In addition to history and physical examination, evaluation of a patient with shoulder pain often involves assessment of the cuff with a diagnostic test such as sonography or MRI. A review of the sonography literature has shown sensitivities ranging from % and specificities from % for the detection of full-thickness rotator cuff tears in series that varied in size from 38 to 71 patients and used surgery as a gold standard [1 8]. These wide ranges can be explained in part by the use of sonographic criteria that have since been refined or changed, use of older equipment and lower frequency transducers, or use of a scan technique that has since been modified to improve cuff visualization [4, 7]. Only a few series of 15 to 27 patients have reported sensitivities and specificities for detecting partial-thickness tears, with ranges from 41 93% and 85 94%, respectively [1, 2, 9]. One of these latter studies may have experienced some of the limitations described above [2]; however, none of the studies explained the causes for their interpretation errors nor have reasons for errors been reported, to our knowledge. The purpose of this study was to analyze the causes of the errors for the detection and measurement of rotator cuff tears in our patient population. Subjects and Methods Patients The study comprised 71 consecutive patients with acute or chronic shoulder pain who had undergone preoperative sonography and subsequent arthroscopy between December 1998 and April Forty-one men and 30 women participated, with a mean age of 59 (range, years old). Our institutional review board approved the study protocol and informed consent was obtained from all patients. The arthroscopic or surgical diagnoses were a full-thickness tear of the rotator cuff in 46 (65%) 1768 AJR:184, June 2005
2 Detection of Rotator Cuff Tears with Sonography patients, a partial-thickness tear in 19 (27%), and no tear in six (8%). Of the six patients with no tear, chronic tendinitis was diagnosed in four and adhesive capsulitis in one; one patient had a normal cuff. Eight patients (11%) had subscapularis tendon tears, seven of whom had associated full-thickness tears involving at least the supraspinatus tendon. Imaging and Surgical Techniques All sonograms were obtained with an Elegra scanner (Siemens Medical Solutions) using a highfrequency, MHz linear array transducer. Real-time scanning of the shoulder was performed in a standardized fashion as described by Teefey et al. [1]. In nearly all cases, harmonic imaging was performed with a transmit frequency of 4.5 MHz. A single subspecialty-trained shoulder surgeon performed all arthroscopic examinations and surgeries. Representative arthroscopic images and videotapes were made of all tears. Imaging and Surgical Interpretation One of two radiologists similarly experienced with musculoskeletal sonography prospectively obtained and interpreted each sonogram. Established criteria were used for the diagnosis of a fullor partial-thickness tear [1, 3, 9]. For each sonogram, the absence or presence of a full- or partialthickness rotator cuff tear was recorded. The length of a partial-thickness tear or degree of retraction of a full-thickness tear (measured on longitudinal views oriented parallel to the long axis of the cuff) and width (measured on transverse views oriented perpendicular to the long axis of the cuff) were also recorded. When the width was greater than 30 mm, an attempt was often made to measure it with extended field-of-view imaging. The presence or absence of a subscapularis tendon tear was recorded separately without measurements. Each radiologist also recorded whether the sonogram was diagnostic, suboptimal but diagnostic, or nondiagnostic. At arthroscopy, the orthopedic surgeon, who was not blinded to the sonographic findings, recorded the absence or presence of a full- or partialthickness rotator cuff tear. The degree of retraction or length and the width of each tear were measured with a linear tool notched with 1-mm marks. The presence or absence of a subscapularis tendon tear was also recorded. Representative arthroscopic images were taken of all tears. Data Analysis Diagnoses and measurements made with sonography were compared with the arthroscopic findings. Findings were compared for the presence or absence of a full- or partial-thickness tear, tear length or retraction, and tear width. Sonographic measurements within 5 mm of the measurement recorded at arthroscopy were considered correct. Tears 30 mm or greater in width and those retracted beneath the acromion were assigned a value of 30 mm. When discrepant findings between sonography and arthroscopy were found, sonographic and representative arthroscopic images were retrospectively reviewed jointly by one radiologist and the orthopedic surgeon to determine the cause of the discrepancy. In one discrepant case, arthroscopic images were not available for review. Afterward, the causes for the detection errors (including subscapularis tears) were categorized as follows: inherent with the test (i.e., the study would have been interpreted the same way in retrospect based on the standard sonographic criteria for diagnosing a tear), inherent with the patient (i.e., an inability to perform the test because of patient limitations), misinterpretation of a finding (the abnormality was identified but misinterpreted), a miss (no abnormality detected), and an unknown cause. The causes for measurement errors were descriptive. Results Detection of Rotator Cuff Tears Of the 46 full-thickness rotator cuff tears, there was only one diagnostic error and it was due to misinterpretation of a finding. In this case, an extensive partial-thickness tear rather than a full-thickness tear was diagnosed. A review of the images showed a contour deformity of the cuff. All 46 sonograms were considered diagnostic. Of the 19 partial-thickness rotator cuff tears, six diagnostic errors occurred. In two cases, the finding was missed. In these two cases, a review of the representative sonographic images showed a normal-appearing cuff (Fig. 1). The articular-side partial-thickness tears measured 5 15 mm and 15 5 mm (length width) on arthroscopy. In the other four cases, full-thickness tears were diagnosed. In two of these cases, large bursal-side, partial-thickness tears were found on arthroscopy involving most of the cuff (in one case, more than 90% of the cuff fibers were torn) (Fig. 2) and in another case, a markedly thinned cuff with an extensive partial-thickness tear was found (Fig. 3). These three errors were categorized as inherent with the test. In the fourth case, the cause for the error was unknown. A review of the representative arthroscopic images showed no full-thickness tear; however, the sonographic images showed a small contour defor- A B Fig year-old woman with an articular-side, partial-thickness tear. A, Longitudinal sonographic image shows a normal, intact cuff. B, Transverse sonographic image shows a normal, intact cuff. The small tear was missed. It measured 5 (length) 15 (width) mm at surgery. BT = biceps tendon. AJR:184, June
3 Teefey et al. Fig year-old man with an extensive bursal-side tear involving greater than 90% of the cuff. Longitudinal image shows a 1-cm tear (cursors) surrounded by fluid with a few intact articular-side fibers that was interpreted as full-thickness tear on the sonogram. Tear was detected but misinterpreted due to inherent limitations of the test. mity of the cuff. All 19 sonograms were considered diagnostic. Of the eight subscapularis tendon tears, four diagnostic errors were found. A review of the sonographic images in three cases showed no tear. All three of these errors were categorized as misses. In all three cases, the subscapularis tears were < 5-mm partialthickness tears of the superior aspect of the tendon as noted on arthroscopy. Sonographic visualization of the subscapularis tendon was hindered by limited external rotation in the fourth case and was the only case considered nondiagnostic. This error was categorized as inherent with the patient. Two subscapularis tendon tears were diagnosed with sonography in patients with intact subscapularis tendons on arthroscopy (Fig. 4). In one of these cases, a tear involving the supraspinatus and infraspinatus tendons was noted to extend over the rotator interval on arthroscopy although it did not involve the subscapularis tendon. The arthroscopic images were not available for review in the second case. Review of the sonographic images showed a small defect in the subscapularis tendon. The first diagnostic error was categorized as a misinterpretation of the findings and the second as from an unknown cause. Of the six intact cuffs, two diagnostic errors were found. A small full-thickness tear was diagnosed in one case that was found to have adhesive capsulitis without a tear on arthroscopy. Review of the sonographic images showed a small contour deformity of the cuff (Fig. 5) but no tear was identified on review of the arthroscopic images. The cause for this error was categorized as unknown. In the second case, a tiny partial-thickness tear was reported; chronic tendinitis was found on arthroscopy. Review of the sonographic images showed a tiny hypoechoic region at the articular side of the cuff. This error was categorized as inherent with the test. All six sonographic studies were considered diagnostic. Size and Extent of the Tears Of the 45 full-thickness rotator cuff tears correctly diagnosed on sonography, 11 errors were in tear retraction and six were errors in tear-width measurements. Retraction was overestimated in eight cases and underestimated in three. In all but one case, large or massive tears (20 45 mm in width) were found on arthroscopy. In two of the three cases in which retraction was underestimated, the medial torn ends were retracted beneath the acromion. In three of the cases in which tear retraction was overestimated and in one case in which it was underestimated, a review of the sonograms showed bursal thickening. In another case, review of the arthroscopic images showed a complex, irregularly shaped tear. In the remaining four cases, a cause for the errors could not be determined. Tear width was underestimated in three cases and overestimated in three. In five of these cases, tear widths measured mm on arthroscopy. In two of the three cases in which tear width Fig year-old woman with a markedly thinned, extensive partial-thickness tear involving almost the entire rotator cuff. Longitudinal image shows flattening of the cuff and loss of cuff substance (cursors) that was interpreted as a full-thickness tear on the sonogram. The tear was detected but misinterpreted due to the inherent limitations of the test AJR:184, June 2005
4 Detection of Rotator Cuff Tears with Sonography Fig year-old woman with a full-thickness rotator cuff tear involving the supraspinatus and infraspinatus tendons extending over the rotator interval but not involving the subscapularis tendon. The longitudinal image of the subscapularis tendon shows defect (cursors) that was misinterpreted as a full-thickness tear on the sonogram. was underestimated, portions of the tears were nonretracted. A review of the arthroscopic and sonographic images showed no apparent reasons for the remaining four errors. Of the 13 partial-thickness tears that were correctly diagnosed with sonography, two errors had occurred in tear length and six in tearwidth measurements. In one of the two cases in which tear-length measurements were underestimated, a review of the arthroscopic images showed a complex tear with multiple, separate components and in the other case, a review of the sonograms showed a hypoechoic region that was larger than what was measured. In two of the six cases in which tear widths were underestimated, a review of the arthroscopic showed irregularly shaped tears. In two other cases, a review of the sonograms showed apparent hypoechoic regions on transverse images that were larger than what was measured (Fig. 6). In the remaining two cases, a cause for the measurement errors could not be determined. Discussion Although infrequent, we found a wide variety of causes for errors when diagnosing and measuring rotator cuff tears (Table 1). All of our misses occurred in patients with small partialthickness tears; three were in patients with < 5- mm partial-thickness subscapularis tears. Given the size and partial-thickness nature of these tears, it is not surprising that they were missed. Although the clinical significance of these tiny partial-thickness subscapularis tears is unknown, full-thickness subscapularis tears, which are clinically important, can accurately be diagnosed with sonography [10]. The only other misses occurred in patients with small articular-side partial-thickness tears. It has been reported that sonography is less accurate for diagnosing partial-thickness tears compared with full-thickness tears [8]. This may be due to the difficulty in distinguishing tendinopathy from some partial-thickness tears. Although little has been written on the sonographic appearance of tendinopathy apart from brief comments in musculoskeletal sonography textbooks [11], which have described a focal hypoechoic region, our experience suggests that it can be difficult to differentiate these two entities in some cases. This distinction, however, may not be clinically relevant because both are initially managed nonoperatively. We found that one third of our diagnostic errors were inherent with the test or patient and beyond the control of the radiologist. One of these errors occurred because of difficulty distinguishing an extensive partial-thickness tear from a full-thickness tear on sonography (Fig. 3). The error occurred because of the substantial loss of cuff substance and compressibility of the few remaining fibers with the transducer. One study reported that an extensive partial-thickness tear involving greater than 50% of the cuff substance can mimic a full-thickness tear by virtue of its compressibility [1]. Large partialthickness bursal-side tears can also be mistaken for full-thickness tears (Fig. 2). A large bursalside cuff tear, by virtue of its size and location, Fig year-old man with adhesive capsulitis and an intact cuff. The longitudinal image shows contour deformity (cursors) of the supraspinatus tendon that was interpreted as a full-thickness tear on the sonogram. The reason for the error could not be determined. AJR:184, June
5 Teefey et al. Fig year-old woman with an articular-side, partial-thickness supraspinatus tear. Transverse image shows the original measurement of the tear width (cursors), which was underestimated. The more likely tear width (arrows) correlates with the arthroscopic measurement of 15 mm. BT = biceps tendon. will appear on sonography as a contour deformity and simulate a full-thickness tear, as in two of our cases. This difficulty in distinguishing partial- and full-thickness tears has recently been shown as the primary cause of interobserver variability between two experienced observers [12]. Clinically, a failure to distinguish extensive partial-thickness from full-thickness tears may not be important because orthopedic surgeons generally treat extensive partial-thickness tears or large bursal-side tears as if they were full-thickness ones. Difficulty distinguishing tendinopathy from an articular-side partial-thickness tear was another source of error inherent with the test but occurred only once. As stated earlier, differentiating these two entities can be problematic. Only one error was inherent with the patient; this error occurred when sonographic visualization of the subscapularis tendon was hindered by a limited range of motion, as the patient was unable to externally rotate his arm to evaluate the tendon. This was the only case in our study in which such a limitation occurred, indicating that it is rare. We were unable to determine the causes of the diagnostic errors in three cases. One occurred in a patient with a partial-thickness tear; MRI and sonography showed a contour deformity in the cuff, suggestive of a fullthickness tear. The second error occurred in a patient thought to have a partial-thickness subscapularis tear; unfortunately, arthroscopic images were not available for review. In the third case, a patient with adhesive capsulitis was diagnosed with a small full-thickness tear, also reported in an MRI study (Fig. 5). Although it is difficult to explain these errors, it is possible that small tears may have been missed on arthroscopy. Sonographic findings were rarely misinterpreted. In one case, a contour deformity was TABLE 1 present on sonography, but an extensive partial-thickness tear was diagnosed rather than a full-thickness tear due to the perceived presence of intact bursal-side fibers during realtime scanning. One study reported that extensive partial-thickness tears can produce a cuff defect [1]. Nevertheless, had the cuff defect, an important criterion for the diagnosis of a fullthickness tear, been interpreted as such, the error would not have occurred. The only other error occurred in a patient thought to have a subscapularis tear (Fig. 4). The arthroscopic images showed a supraspinatus tear that extended over the rotator interval but did not involve the tendon. This subtle distinction was almost certainly the cause for the error. MRI also diagnosed a subscapularis tear in this case. We found that most of the retraction-measurement errors in patients with full-thickness tears occurred with large or massive tears. Although it was difficult to determine the exact cause of the discrepant measurements in every case, we speculate that several factors may have contributed. First, because large and massive tears can be irregularly shaped, it is doubtful that both sets of measurements were obtained at the same location in these cases. In addition, when bursal thickening was present, it was more difficult to determine the precise location of the torn tendon ends. Shoulders were also positioned differently during sonography and surgery. During sonography, the shoulder was extended and the elbow flexed and directed medially; this may have increased the distance between the torn tendon ends and may have caused local muscle groups to contract, resulting in further medial retraction. At surgery, the humeral head was reduced to an anatomic position, allowing the torn ends of the cuff to return to their relaxed positions. An inability to visualize the medial torn tendon end beneath the acromion was another cause for discrepant measurements. In such cases, an accurate measurement could not be obtained. Nevertheless, reporting the location of the torn tendon end as retracted beneath the acromion provided useful information to the orthopedic surgeon. Although far fewer tear-width measurement errors for full-thickness tears occurred, the tears were again large or massive in the majority of cases. We found it difficult to measure large or massive tear widths along a curved surface. In some cases, we used extended field-of-view imaging to better show the width of a large or massive tear and overcome the usual limitations of a small field of view. Nevertheless, an accurate Detection of Rotator Cuff Tears with Sonography Diagnostic Errors Sonographic Findings Inherent with Total Misinterpretation Miss Unknown Test Patient Full-thickness tear Partial-thickness tear Subscapularis tear Intact cuff Total AJR:184, June 2005
6 Detection of Rotator Cuff Tears with Sonography measurement could not be obtained because the resultant image was often foreshortened. In those cases in which tear widths were underestimated, arthroscopic images showed that a portion of the tears were nonretracted; these portions were most likely not included in the measurements accounting for the errors. Few errors occurred when measuring partial-thickness tear lengths; however, tear widths were underestimated on sonography in nearly one half of the cases. The irregular shape of the cuff tear was thought to be responsible for the incorrect sonographic measurements in two cases due to difficulty measuring such tears at the same location as arthroscopy. In two other cases, review of the sonographic images showed hypoechoic regions on transverse views that were larger than what was measured (Fig. 6). Difficulty distinguishing tendinopathy from the tear most likely accounted for these errors. All but one of the sonographic studies was considered diagnostic. Body habitus was not a limiting factor in our study, nor was it a cause of subdiagnostic or nondiagnostic studies. The one nondiagnostic study occurred in a patient with limited external rotation of his arm and only hindered evaluation of the subscapularis tendon. Our study was limited by the fact that the joint review was done months after the arthroscopic and sonographic examinations were completed rather than immediately after surgery. Although the sonographic and arthroscopic studies were performed and measurements obtained prospectively, we were nevertheless unable to determine the exact cause of some of the measurement errors and can only speculate as to the reasons. Had the joint review been done earlier, we may have been able to determine the exact causes of the measurement errors in more cases. Although all of these patients had MRI as part of another study [8], we did not determine if the diagnostic errors made with sonography were the same errors made with MRI. However, we did note that many of the cases that were problematic for sonography were also problematic for MRI [8]. This primarily reflects the difficulty that both tests have in distinguishing extensive partialthickness or large bursal-side tears from fullthickness tears and tendinopathy from partialthickness tears. Given this overlap in diagnostic capabilities, the choice as to which test to order depends on several factors. Based solely on diagnostic accuracy, there is ample evidence to support the use of either test in a patient with a suspected rotator cuff tear [8, 13]. Thus, when determining which test to order, other factors besides accuracy should be considered, including regional expertise with a particular test, the importance of ancillary clinical information (labral, capsular, ligamentous, or bone pathology), patient tolerance, and cost. We found that the patients perception of the test was also an important consideration; in our experience, sonography is preferred to MRI by most patients [14]. In summary, we have shown that detection errors, although infrequent, will occur when obtaining a shoulder sonogram, primarily due to limitations inherent with the test or misses in patients with small partial-thickness tears. From a clinical perspective, these errors should not have a significant impact on patient care. Most measurement errors for full-thickness tears occurred in patients with large or massive tears, errors that may not be rectifiable. References 1. Teefey SA, Hasan SA, Middleton WD, Patel M, Wright RW, Yamaguchi K. Ultrasonography of the rotator cuff: a comparison of ultrasonographic and arthroscopic findings in one hundred consecutive cases. J Bone Joint Surg Am 2000;82: Brenneke SL, Morgan CJ. Evaluation of ultrasonography as a diagnostic technique in the assessment of rotator cuff tendon tears. Am J Sports Med 1992;20: Wiener SN, Seitz WH Jr. Sonography of the shoulder in patients with tears of the rotator cuff: accuracy and value for selecting surgical options. AJR 1993;160: Paavolainen P, Ahovuo J. Ultrasonography and arthrography in the diagnosis of tears of the rotator cuff. J Bone Joint Surg Am 1994;17: Hodler J, Fretz CJ, Terrier F, Gerber C. Rotator cuff tears: correlation of sonographic and surgical findings. Radiology 1988;169: Mack LA, Matsen FA III, Kilcoyne RF, Davies PK, Sickler ME. US evaluation of the rotator cuff. Radiology 1985;157: Brandt TD, Cardone BW, Grant TH, Post M, Weiss CA. Rotator cuff sonography: a reassessment. Radiology 1989;173: Teefey S, Rubin D, Middleton W, Hildebolt C, Leibold R, Yamaguchi K. Detection and quantification of rotator cuff tears: a comparison of ultrasonographic, magnetic resonance imaging and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am 2004;86: van Holsbeeck MT, Kolowich PA, Eyler WR, et al. US depiction of partial-thickness tear of the rotator cuff. Radiology 1995;197: Farin P, Jaroma H. Sonographic detection of tears of the anterior portion of the rotator cuff (subscapularis tendon tears). J Ultrasound Med 1996;16: Ptaszink R. Sonography of the shoulder. In: van Holsbeeck MT, Introcaso JH, eds. Musculoskeletal ultrasound, 2nd ed. St. Louis, MO: Mosby, 2001: Middleton WD, Teefey SA, Yamaguchi K. Sonography of the rotator cuff: analysis of interobserver variability. AJR 2004;183: Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review. Health Technol Assess 2003;7: Middleton WD, Payne WT, Teefey SA, Hildebolt CF, Yamaguchi K. Sonography and MRI of the shoulder: comparison of patient satisfaction. AJR 2004;183: AJR:184, June
Ultrasonography of the Rotator Cuff
Ultrasonography of the Rotator Cuff A COMPARISON OF ULTRASONOGRAPHIC AND ARTHROSCOPIC FINDINGS IN ONE HUNDRED CONSECUTIVE CASES* BY SHARLENE A. TEEFEY, M.D., S. ASHFAQ HASAN, M.D., WILLIAM D. MIDDLETON,
More informationSonographic Differences in the Appearance of Acute and Chronic Full-Thickness Rotator Cuff Tears
Sonographic Differences in the Appearance of Acute and Chronic Full-Thickness Rotator Cuff Tears Sharlene A. Teefey, MD, William D. Middleton, MD, Gregory S. Bauer, MD, Charles F. Hildebolt, DDS, PhD,
More informationDISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS
DISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS Lyndon B. Gross M.D. Ph.D. The Orthopedic Center of St. Louis SHOULDER PAIN Third most common musculoskeletal
More informationThe demographic and morphological features of rotator cuff disease: A comparison of asymptomatic and symptomatic shoulders
Washington University School of Medicine Digital Commons@Becker Open Access Publications 8-1-2006 The demographic and morphological features of rotator cuff disease: A comparison of asymptomatic and symptomatic
More informationComparison of the results of ultrasonographic evaluation and arthroscopy in patients scheduled for surgery of the supraspinatus tendon rupture
Comparison of the results of ultrasonographic evaluation and arthroscopy in patients scheduled for surgery of the supraspinatus tendon rupture Cemille Görmeli, a Gökay Görmeli, b Cüneyt Yücesoy, c Baybars
More informationComparative Study of MRI and Operative Findings in Rotator Cuff Tears. University of Medical Sciences, Iran. Medical Sciences, Iran.
Comparative Study of MRI and Operative Findings in Rotator Cuff s Mohammad Hossein Daghighi 1, Alireza Rouhani 2, Masoud oureisa 3, Ali Sadighi 4, Farnaz Hafez Quran 5 *, Masoumeh Ahmadi Mohtasham 5 1.
More informationOffice-based Versus Radiologist-based Ultrasonography for the Diagnosis of Rotator Cuff Tears
Article ID: WMC003756 ISSN 2046-1690 Office-based Versus Radiologist-based Ultrasonography for the Diagnosis of Rotator Cuff Tears Corresponding Author: Mr. Chetan S Modi, Shoulder and Elbow Fellow, Toronto
More informationUltrasound study of the asymptomatic shoulder in patients with a confirmed rotator cuff tear in the opposite shoulder
original research ARTICLE Ultrasound study of the asymptomatic shoulder in patients with a confirmed rotator cuff tear in the opposite shoulder Z Oschman (MB ChB, DCH, MSc (Sports Medicine)) 1 C Janse
More informationUltrasound of the Shoulder
Ultrasound of the Shoulder Patrick Battaglia, DC, DACBR Logan University, Department of Radiology Outline Review ultrasound appearance of NMSK tissues Present indications for ultrasound of the shoulder.
More informationSonographic versus magnetic resonance arthrographic evaluation of full-thickness rotator cuff tears in millimeters
Sonographic versus magnetic resonance arthrographic evaluation of full-thickness rotator cuff tears in millimeters Rainer Kluger, MD, a Rudolf Mayrhofer, MD, b Andreas Kröner, MD, a Christoph Pabinger,
More informationAPPROPRIATE USE GUIDELINES
APPROPRIATE USE GUIDELINES Appropriateness of Advanced Imaging Procedures (MRI, CT, Bone Scan/PET) in Patients with Shoulder Pain CDI QUALITY INSTITUTE: PROVIDER LED ENTITY (PLE) Compiled by Rob Liddell,
More informationMusculoskeletal Imaging Original Research
MR rthrography fter Rotator Cuff Repair Musculoskeletal Imaging Original Research C M E D E N T U R I C L I M G I N G JR 2006; 186:237 241 0361 803X/06/1861 237 merican Roentgen Ray Society Y Sylvain R.
More informationUS finding of the shoulder (with live demonstration) 인제의대상계백병원 안재기
US finding of the shoulder (with live demonstration) 인제의대상계백병원 안재기 Shoulder US Biceps tendon & Rotator Cuff Long Head of Biceps Tendon Subscapularis tendon Supraspinatus tendon Infraspinatus tendon Teres
More informationProvider Led Entity. CDI Quality Institute PLE Shoulder AUC 05/22/2018
Provider Led Entity CDI Quality Institute PLE Shoulder AUC 05/22/2018 Appropriateness of advanced imaging procedures* in patients with shoulder pain and the following clinical presentations: *Including
More informationMusculoskeletal Ultrasound. Technical Guidelines SHOULDER
Musculoskeletal Ultrasound Technical Guidelines SHOULDER 1 Although patient s positioning for shoulder US varies widely across different Countries and Institutions reflecting multifaceted opinions and
More informationROTATOR CUFF DISORDERS/IMPINGEMENT
ROTATOR CUFF DISORDERS/IMPINGEMENT Dr.KN Subramanian M.Ch Orth., FRCS (Tr & Orth), CCT Orth(UK) Consultant Orthopaedic Surgeon, Special interest: Orthopaedic Sports Injury, Shoulder and Knee Surgery, SPARSH
More informationROTATOR CUFF INJURIES / IMPINGEMENT SYNDROME
ROTATOR CUFF INJURIES / IMPINGEMENT SYNDROME Shoulder injuries are common in patients across all ages, from young, athletic people to the aging population. Two of the most common problems occur in the
More information11/13/2017. Disclosures: The Irreparable Rotator Cuff. I am a consultant for Arhtrex, Inc and Endo Pharmaceuticals.
Massive Rotator Cuff Tears without Arthritis THE CASE FOR SUPERIOR CAPSULAR RECONSTRUCTION MICHAEL GARCIA, MD NOVEMBER 4, 2017 FLORIDA ORTHOPAEDIC INSTITUTE Disclosures: I am a consultant for Arhtrex,
More informationA Comparison of Conventional Ultrasonography and Arthrosonography in the Assessment of Cuff Integrity after Rotator Cuff Repair
Original Article Clinics in Orthopedic Surgery 2014;6:336-342 http://dx.doi.org/10.4055/cios.2014.6.3.336 A Comparison of Conventional Ultrasonography and Arthrosonography in the Assessment of Cuff Integrity
More informationOriginal Research Article
Original Research Article Study of Rotator Cuff Disorders by Ultrasound with Magnetic Resonance Imaging Correlation Hemanth Purigali Naganna 1, Shashikumar Mysore Rangaswamy 2, Jaganathan 3, Nanjaraj Chakenalli
More informationCase study # 6 Sharon P
Patient is a morbidly obese 70 year old female presenting with left shoulder pain after a severe fall. Patient is in moderate to severe pain with extremely limited range of motion due to extensive shoulder
More informationCommon Applications for Sonography and Guided Intervention: Shoulder
Common Applications for Sonography and Guided Intervention: Shoulder Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Disclosures: Consultant:
More informationMRI and Sonography of the Shoulder
Clinical Radiology (1991) 43, 323-327 and of the Shoulder J. HODLER, B. TERRIER*, G. K. yon SCHULTHESS and W. A. FUCHS Departments of Medical Radiology and *Rheumatology, University Hospital, Zurich, Switzerland
More informationUltrasound assessment of most frequent shoulder disorders
Ultrasound assessment of most frequent shoulder disorders Poster No.: C-2026 Congress: ECR 2014 Type: Educational Exhibit Authors: S. P. Ivanoski; Ohrid/MK Keywords: Trauma, Athletic injuries, Arthritides,
More informationShoulder ultrasonography performed by orthopedic surgeons increases efficiency in diagnosis of rotator cuff tears
Chiu et al. Journal of Orthopaedic Surgery and Research (2017) 12:63 DOI 10.1186/s13018-017-0565-4 RESEARCH ARTICLE Shoulder ultrasonography performed by orthopedic surgeons increases efficiency in diagnosis
More informationMRI of the Shoulder What to look for and how to find it? Dr. Eric Handley Musculoskeletal Radiologist Cherry Creek Imaging
MRI of the Shoulder What to look for and how to find it? Dr. Eric Handley Musculoskeletal Radiologist Cherry Creek Imaging MRI of the Shoulder Benefits of Ultrasound: * Dynamic * Interactive real time
More informationSuperior Labrum Anterior Posterior lesions: ultrasound evaluation
Superior Labrum Anterior Posterior lesions: ultrasound evaluation Poster No.: C-0472 Congress: ECR 2017 Type: Scientific Exhibit Authors: D. Belyaev; Yaroslavl/RU Keywords: Trauma, Arthrography, Ultrasound,
More informationRotator Cuff and Biceps Pathology
Rotator Cuff and Biceps Pathology Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Disclosures: Consultant: Bioclinica Advisory Board:
More informationMRI SHOULDER WHAT TO SEE
MRI SHOULDER WHAT TO SEE DR SHEKHAR SRIVASTAV Sr. Consultant- Knee & Shoulder Arthroscopy Sant Parmanand Hospital Normal Anatomy Normal Shoulder MRI Coronal Oblique Sagital Oblique Axial Cuts Normal Coronal
More informationIs ultrasonographic evaluation of rotator interval useful in diagnosis of adhesive capsulitis of shoulder?
Is ultrasonographic evaluation rotator interval useful in diagnosis adhesive capsulitis shoulder? Poster No.: C-2230 Congress: ECR 2011 Type: Scientific Paper Authors: Y. C. Yoon, J. M. Seo, H. S. Kim,
More informationMassive Rotator Cuff Tears. Rafael M. Williams, MD
Massive Rotator Cuff Tears Rafael M. Williams, MD Rotator Cuff MRI MRI Small / Partial Thickness Medium Tear Arthroscopic View Massive Tear Fatty Atrophy Arthroscopic View MassiveTears Tear is > 5cm
More informationConsiderations 3/9/2018. Asheesh Bedi, MD. I have no disclosures or conflicts of interest related to the content of this presentation.
Radiological Assessment of the Rotator Cuff What predicts outcomes? Asheesh Bedi, MD Harold and Helen W. Gehring Professor Chief, Sports Medicine & Shoulder Surgery MedSport, Department of Orthopedic Surgery
More informationDiagnostic accuracy of ultrasound for rotator cuff tears
Diagnostic accuracy of ultrasound for rotator cuff tears Kelechi R. Okoroha 1, Mohsin S. Fidai 1, Joseph S. Tramer 1, Kayla D. Davis 2, Patricia A. Kolowich 1 1 Department of Orthopaedic Surgery, Henry
More informationRotator Cable: MRI Study of Its Appearance in the Intact Rotator Cuff With Anatomic and Histologic Correlation
Musculoskeletal Research Original Research Gyftopoulos et al. MRI of Rotator Cable in Intact Rotator Cuff Musculoskeletal Research Original Research Downloaded from www.ajronline.org by 148.251.232.83
More informationThe Shoulder. Systematically scanning the shoulder provides extremely useful diagnostic information. The Shoulder
1 ! The most ACCESSIBLE to sonographic exam! The most MOBILE and VULNERABLE extremity AND Systematically scanning the shoulder provides extremely useful diagnostic information! The Goal for this section
More informationIntroduction. Al Kindy Col Med J 2012; Vol. 8 No. 1 P: 63
Ultrasound of the Rotator Cuff: A Comparison of Ultrasonographic and Physical Examination Finding in Seventy Consecutive Cases *Mohammed S. Al- Iedani, F.I.C.M.S. * Ghadeer H. Majeed, F.I.C.M.S. ** Tamer
More informationThe use of Ultrasound of the shoulder as a screening method for rotator cuff tear; A single institution experience
The use of Ultrasound of the shoulder as a screening method for rotator cuff tear; A single institution experience Poster No.: C-0596 Congress: ECR 2014 Type: Scientific Exhibit Authors: R. A. Ahyad, Z.
More informationShoulder Ultrasonography as a Diagnostic Tool for Rotator Cuff Disease
Shoulder Ultrasonography as a Diagnostic Tool for Rotator Cuff Disease Jay D Keener, MD Associate Professor Shoulder and Elbow Service Washington University Disclosure No relevant financial disclosures
More informationDynamic Sonography Evaluation of Shoulder Impingement Syndrome
Sonography of Shoulder Impingement Syndrome Musculoskeletal Imaging Clinical Observations A C M E D E N T U R I C A L I M A G I N G AJR 2006; 187:216 220 0361 803X/06/1871 216 American Roentgen Ray Society
More informationUltrasound of the Shoulder: Asymptomatic Findings in Men
Musculoskeletal Imaging Original Research Girish et al. Shoulder Ultrasound Findings Musculoskeletal Imaging Original Research Gandikota Girish 1 Lucas G. Lobo 1 Jon A. Jacobson 1 Yoav Morag 1 Bruce Miller
More informationPartial Thickness Rotator Cuff Tears: All-Inside Repair of PASTA Lesions in Athletes
Partial Thickness Rotator Cuff Tears: All-Inside Repair of PASTA Lesions in Athletes Thomas M. DeBerardino, MD Associate Professor, UConn Health Center Team Physician, Orthopaedic Consultant UConn Huskie
More informationThe Role of Sonography in Differentiating Full Versus Partial Distal Biceps Tendon Tears: Correlation With Surgical Findings
Musculoskeletal Imaging Original Research Da Gama Lobo et al. Sonography in Biceps Tendon Tears Musculoskeletal Imaging Original Research Lucas Da Gama Lobo 1,2 David P. Fessell 1 Bruce S. Miller 1,3 Aine
More informationModified Oblique Sagittal Magnetic Resonance Imaging of Rotator Cuff Tears: Comparison with Standard Oblique Sagittal Images
Journal of Magnetics 22(3), 519-524 (2017) ISSN (Print) 1226-1750 ISSN (Online) 2233-6656 https://doi.org/10.4283/jmag.2017.22.3.519 Modified Oblique Sagittal Magnetic Resonance Imaging of Rotator Cuff
More informationMusculoskeletal Ultrasound Fundamentals
Fundamentals Benjamin D. Levine, M.D. Associate Professor of Radiology Musculoskeletal Imaging Dept. of Radiological Sciences UCLA Health System I. Image Optimization II. Image Interpretation Artifacts
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Correlation between High Resolution Ultrasonography and MRI in Rotator Cuff Tear Diagnosis
More informationUltrasound of Shoulder Pathology and Intervention 서울대학교병원재활의학과 김기원
Ultrasound of Shoulder Pathology and Intervention 서울대학교병원재활의학과 김기원 Ultrasound for Shoulder Disorder Advantage Dynamic evaluation Immediate clinical correlation + Intervention Weakness Diagnostic accuracy?
More informationManagement of Massive/Revision Rotator Cuff Tears
Management of Massive/Revision Rotator Cuff Tears Nikhil N. Verma MD, Director Sports Medicine, Rush University Medical Center, Midwest Orthopedics at Rush, Chicago, IL nverma@rushortho.com I. Anatomy
More informationRole of Magnetic Resonance Imaging in Internal Derangement of Shoulder
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 5 Ver. I (May. 2016), PP 22-26 www.iosrjournals.org Role of Magnetic Resonance Imaging in Internal
More informationSensitivity and Specificity in Detection of Labral Tears with 3.0-T MRI of the Shoulder
Magee and Williams MRI for Detection of Labral Tears Musculoskeletal Imaging Clinical Observations C M E D E N T U R I C L I M G I N G JR 2006; 187:1448 1452 0361 803X/06/1876 1448 merican Roentgen Ray
More informationSports Medicine: Shoulder Arthrography. Christine B. Chung, M.D. Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System
Sports Medicine: Shoulder Arthrography Christine B. Chung, M.D. Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System Disclosure Off-label use for gadolinium Pediatric Sports Injuries
More informationImpingement syndrome. Clinical features. Management. Rotator cuff tear diagnosed. Go to rotator cuff tear
Impingement syndrome Clinical features Management Poor response Good response Refer to orthopaedic surgery R Review as appropriate Investigations Rotator cuff tear diagnosed Go to rotator cuff tear Consider
More informationAnatomy Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
Shoulder Impingement/Rotator Cuff Tendinitis One of the most common physical complaints is shoulder pain. Your shoulder is made up of several joints combined with tendons and muscles that allow a great
More informationDelaminated Tears of the Rotator Cuff: Prevalence, Characteristics, and Diagnostic Accuracy Using Indirect MR Arthrography
Musculoskeletal Imaging Original Research Choo et al. MR Arthrography of Delaminated Tears of the Rotator Cuff Musculoskeletal Imaging Original Research Hye Jung Choo 1 Sun Joo Lee 1 Jung-Han Kim 2 Dong
More informationShort term results of arthroscopic repair of subscapularis tendon tear
Original Research Medical Journal of the Islamic Republic of Iran.Vol. 23, No. 3, November, 2009. pp. 117-121 Short term results of arthroscopic repair of subscapularis tendon tear Hamid Reza Aslani, MD.
More informationRESULTS. Three patients in the LB group and 4 patients in the EB group were lost to follow up, and these patients
RESULTS Three patients in the LB group and 4 patients in the EB group were lost to follow up, and these patients were excluded from the analysis. Finally, 71 patients were included in the analysis (36
More informationAMSER Case of the Month January 2019
AMSER Case of the Month January 2019 55 yo female presenting with 1 year of shoulder pain without prior trauma Nicholas Bertha, MS4 Drexel University College of Medicine Brandon Schooley, MD Allegheny
More informationAssessment of the Postoperative Appearance of the Rotator Cuff Tendon Using Serial Sonography After Arthroscopic Repair of a Rotator Cuff Tear
ORIGINAL RESEARCH Assessment of the Postoperative Appearance of the Rotator Cuff Tendon Using Serial Sonography After Arthroscopic Repair of a Rotator Cuff Tear Hye Jin Yoo, MD, Ja-Young Choi, MD, Sung
More informationCOMPARISON OF COMPLEMENTARY EXAMS IN THE DIAGNOSIS OF ROTATOR CUFF INJURIES
ARTIGO ORIGINAL COMPARISON OF COMPLEMENTARY EXAMS IN THE DIAGNOSIS OF ROTATOR CUFF INJURIES Gabriel El-Kouba, Thomas Andreas Huber, José Renato Wilke Freitas, Valdir Steglich, Henrique Ayzemberg, Adriano
More informationCLINICAL ARTICLE. Abstract. Diagnostic applications of shoulder sonography Rotator cuff tears
Page 66 / SA ORTHOPAEDIC JOURNAL Autumn 2011 Vol 10 No 1 C L I N I C A L A RT I C L E Ultrasound and the shoulder surgeon Joe de Beer MBChB, MMed (Ortho) Karin van Rooyen MBChB Hans van der Bracht MD Cape
More informationMusculoskeletal Imaging Clinical Observations
MRI of Internal Impingement of the Shoulder Musculoskeletal Imaging Clinical Observations Eddie L. Giaroli 1 Nancy M. Major Laurence D. Higgins Giaroli EL, Major NM, Higgins LD DOI:10.2214/AJR.04.0971
More informationResearch Article Ultrasonographic Validation of Anatomical Landmarks for Localization of the Tendon of the Long Head of Biceps Brachii
Hindawi BioMed Research International Volume 2017, Article ID 1925104, 5 pages https://doi.org/10.1155/2017/1925104 Research Article Ultrasonographic Validation of Anatomical Landmarks for Localization
More informationIntramuscular Rotator Cuff Cysts: Association with Tendon Tears on MRI and Arthroscopy
Kassarjian et al. MRI of Rotator Cuff Cysts and Tendon Tears Musculoskeletal Imaging Clinical Observations Ara Kassarjian 1 Martin Torriani Hugue Ouellette William E. Palmer Kassarjian A, Torriani M, Ouellette
More informationDepartment of Orthopaedic Surgery University of California, Davis
Department of Orthopaedic Surgery University of California, Davis Lloyd W. Taylor Resident Award: Diagnostic Accuracy of MRI in SLAP Tears: A Retrospective Review of 444 Patients Utilizing Musculoskeletal
More informationLongitudinal Split of the Peroneus Longus and Peroneus Brevis Tendons with Disruption of the Superior Peroneal Retinaculum
Longitudinal Split of the Peroneus Longus and Peroneus Brevis Tendons with Disruption of the Superior Peroneal Retinaculum Gregory C. Diaz, MD, Marnix van Holsbeeck, MD, Jon A. Jacobson, MD Longitudinal
More informationComparative study of high resolusion ultrasonography and magnetic resonance imaging in diagnosing traumatic knee injuries & pathologies
Original article: Comparative study of high resolusion ultrasonography and magnetic resonance imaging in diagnosing traumatic knee injuries & pathologies Dr. Rakesh Gujjar*, Dr. R. P. Bansal, Dr. Sandeep
More informationTears of the knee menisci frequently occur not. Is There a Role for Sonography in the Diagnosis of Tears of the Knee Menisci?
Is There a Role for Sonography in the Diagnosis of Tears of the Knee Menisci? Roberto Azzoni, MD, Paolo Cabitza, MD Orthopedic and Trauma Surgery Department, Policlinico San Donato Institute, University
More informationSonographic Visualization of the Rotator Cable in Patients With Symptomatic Full-Thickness Rotator Cuff Tears
ORIGINAL RESEARCH Sonographic Visualization of the Rotator Cable in Patients With Symptomatic Full-Thickness Rotator Cuff Tears Correlation With Tear Size, Muscular Fatty Infiltration and Atrophy, and
More informationShoulder Instability. Fig 1: Intact labrum and biceps tendon
Shoulder Instability What is it? The shoulder joint is a ball and socket joint, with the humeral head (upper arm bone) as the ball and the glenoid as the socket. The glenoid (socket) is a shallow bone
More informationPrevalence of Meniscal Radial Tears of the Knee Revealed by MRI After Surgery
Downloaded from www.ajronline.org by 46.3.207.114 on 12/22/17 from IP address 46.3.207.114. Copyright RRS. For personal use only; all rights reserved Thomas Magee 1 Marc Shapiro David Williams Received
More informationRole and Correlation of High Resolution Ultrasound and Magnetic Resonance Imaging in Evaluation of Patients with Shoulder Pain
Signature: Pol J Radiol, 2017; 82: 410-417 DOI: 10.12659/PJR.901540 ORIGINAL ARTICLE Received: 2016.09.13 Accepted: 2016.11.10 Published: 2017.07.28 Authors Contribution: A Study Design B Data Collection
More informationShoulder Arthroscopy. Dr. J.J.A.M. van Raaij. NOV Jaarvergadering Den Bosch 25 jan 2018
Shoulder Arthroscopy Dr. J.J.A.M. van Raaij NOV Jaarvergadering Den Bosch 25 jan 2018 No disclosures Disclosure Shoulder Instability Traumatic anterior Traumatic posterior Acquired atraumatic Multidirectional
More informationConflict of Interest. New Strategies in Rotator Cuff Repair. Objectives. Learner Outcome
Conflict of Interest New Strategies in Rotator Cuff Repair Sheri Lankford, BSN, CNOR I hereby certify that, to the best of my knowledge, no aspect of my current personal or professional situation might
More informationA prospective comparative study of high resolution ultrasound and MRI in the diagnosis of rotator cuff tears
International Journal of Current Research in Medical Sciences ISSN: 2454-5716 P-ISJN: A4372-3064, E -ISJN: A4372-3061 www.ijcrims.com Original Research Article Volume 4, Issue 12-2018 DOI: http://dx.doi.org/10.22192/ijcrms.2018.04.12.013
More informationUsefulness of musculoskeletal ultrasonography for treatment of shoulder pain
CONTINUING EDUCTION COLUMN pissn 1975-8456 / eissn 2093-5951 http://dx.doi.org/10.5124/jkma.2016.59.3.205 견관절통증의치료에서근골격초음파의유용성 정웅교 고려대학교의과대학정형외과학교실 Usefulness of musculoskeletal ultrasonography for treatment
More informationIMAGING OF ROTATOR CUFF PATHOLOGY- IS ULTRASOUND AS GOOD AS MRI
IMAGING OF ROTATOR CUFF PATHOLOGY- IS ULTRASOUND AS GOOD AS MRI Vinoth Alagappan 1, Nirmal Kumar Prabhu 2, Srikanth Moorthy 3, Sreekumar Karumathil Pullara 4, Rajesh Kanann Ramesh 5, Nazar P. K 6, Chinmay
More informationThe Upper Limb II. Anatomy RHS 241 Lecture 11 Dr. Einas Al-Eisa
The Upper Limb II Anatomy RHS 241 Lecture 11 Dr. Einas Al-Eisa Sternoclavicular joint Double joint.? Each side separated by intercalating articular disc Grasp the mid-portion of your clavicle on one side
More informationMR measurements of subcoracoid impingement using a new method and its relationship to rotator cuff pathology at MR arthrography
MR measurements of subcoracoid impingement using a new method and its relationship to rotator cuff pathology at MR arthrography Poster No.: P-0055 Congress: ESSR 2014 Type: Authors: Keywords: DOI: Scientific
More informationFosbury Flop Tear of the Rotator Cuff: Diagnostic Assessment with Magnetic Resonance Arthrography. Running Title: Fosbury Flop Tears
Fosbury Flop Tear of the Rotator Cuff: Diagnostic Assessment with Magnetic Resonance Arthrography Running Title: Fosbury Flop Tears FC Kolo, 1 AJP Schwitzguébel, 2 A Kourhani, 1 PJ Denard, 3 C Charbonnier,
More informationSHOULDER PROBLEMS & ARTHROSCOPIC MANAGEMENT
SHOULDER PROBLEMS & ARTHROSCOPIC MANAGEMENT DR.SHEKHAR SRIVASTAV Sr. Consultant-KNEE & SHOULDER Arthroscopy Sant Parmanand Hospital,Delhi Peculiarities of Shoulder Elegant piece of machinery It has the
More informationJMSCR Vol 06 Issue 02 Page February 2018
www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 71.58 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i2.03 Clinical Presentation and Spectrum
More informationPost-injury painful and locked knee
H R J Post-injury painful and locked knee, p. 54-59 Clinical Case - Test Yourself Musculoskeletal Imaging Post-injury painful and locked knee Ioannis I. Daskalakis 1, 2, Apostolos H. Karantanas 1, 2 1
More informationWhat can Imaging tell us?
What can Imaging tell us? David Connell FRANZCR, FFSEM (UK) Assoc Professor Dept of Medicine, Nursing & Healthcare Monash University, Melbourne, Australia Assoc Professor Sport & Exercise Medicine Research
More informationSLAP Lesions of the Shoulder
Arthroscopy: The Journal of Arthroscopic and Related Surgery 6(4):21&279 Published by Raven Press, Ltd. Q 1990 Arthroscopy Association of North America SLAP Lesions of the Shoulder Stephen J. Snyder, M.D.,
More informationOriginal Report. Sonography of Tears of the Distal Biceps Tendon. Theodore T. Miller 1,2 Ronald S. Adler 3
Theodore T. Miller 1,2 Ronald S. dler 3 Received October 15, 1999; accepted after revision March 21, 2000. Presented at the annual meeting of the merican Roentgen Ray Society, Washington, DC, May 2000.
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 10/6/2012 Radiology Quiz of the Week # 93 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationRotator Cuff Repair Outcomes. Patrick Birmingham, MD
Rotator Cuff Repair Outcomes Patrick Birmingham, MD Outline Arthroscopic Vs. Mini-open Subjective Outcomes Objective Outcomes Timing Arthroscopic Vs. Mini-open Sauerbrey Arthroscopy 2005 Twenty-six patients
More informationEvaluation of the Effusion within Biceps Long Head Tendon Sheath Using Ultrasonography
Original Article Clinics in Orthopedic Surgery 2015;7:351-358 http://dx.doi.org/10.4055/cios.2015.7.3.351 Evaluation of the Effusion within Biceps Long Head Tendon Sheath Using Ultrasonography In Park,
More informationRotator cuff strength following open subscapularis tendon repair
Acta Orthop. Belg., 2008, 74, 173179 ORIGAL STUDY Rotator cuff strength following open subscapularis tendon repair Roger P. VAN RIET, Sean T. O LEARY, Alexander HOOP, Simon N. BELL From the Melbourne Shoulder
More informationSonography of the Medial Collateral Ligament of the Elbow: A Study of Cadavers and Healthy Adult Male Volunteers
Sabrina I. Ward 1,2 Sharlene A. Teefey 1 George A. Paletta, Jr. 3 William D. Middleton 1 Charles F. Hildebolt 1 David A. Rubin 1 Ken Yamaguchi 3 Received March 19, 2002; accepted after revision August
More informationUsefulness of Unenhanced MRI and MR Arthrography of the Shoulder in Detection of Unstable Labral Tears
Musculoskeletal Imaging Original Research Unenhanced MRI and MR rthrography for Unstable Labral Tears Musculoskeletal Imaging Original Research Thomas 1,2 T Keywords: labral tear, MRI, shoulder DOI:10.2214/JR.14.14262
More informationADHESIVE CAPSULITIS (FROZEN SHOULDER)
ADHESIVE CAPSULITIS (FROZEN SHOULDER) Frozen shoulder, or adhesive capsulitis is a condition that generally begins with the gradual onset of pain followed by a limitation of shoulder motion. The discomfort
More informationDK7215-Levine-ch12_R2_211106
12 Arthroscopic Rotator Interval Closure Andreas H. Gomoll Department of Orthopedic Surgery, Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A. Brian J. Cole Departments
More informationArthroscopic Rotator Cuff Repair
Arthroscopic Rotator Cuff Repair CHRISTOPHER S. AHMAD, MD; WILLIAM N. LEVINE, MD; LOUIS U. BIGLIANI, MD Arthroscopic rotator cuff repair offers less pain, quicker recovery, and less stiffness compared
More informationComparisons of the Various Partial- Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation
Comparisons of the Various Partial- Thickness Rotator Cuff Tears on MR rthrography and rthroscopic Correlation Kyung h Chun, MD Min Sung Kim, MD Young Joo Kim, MD Index terms: Shoulder MR arthrography
More informationPassive mobilization after arthroscopic rotator cuff repair is not detrimental in the early postoperative period
Acta Orthop. Belg., 2015, 81, 485-492 ORIGINAL STUDY Passive mobilization after arthroscopic rotator cuff repair is not detrimental in the early postoperative period Pieter-Jan De Roo, Stijn Muermans,
More informationPatient Presentation. Prevalence of Rotator Cu Tears. By Derek S. Shia, M.D.
Rotator Cu Tears By Derek S. Shia, M.D. Rotator cu tears are one of the most common orthopedic problems and e ect more than 17 million persons annually in the United States. The rotator cu is an essential
More informationYour diagnosis? The case: radiologic case study. For answer see page 872
Enhance your diagnostic skills with this test yourself monthly column, which features a radiograph and challenges you to make a diagnosis. The case: A 56-year-old man was suddenly unable to extend his
More informationHow repaired rotator cuff function influences Constant scoring
Orthopaedics & Traumatology: Surgery & Research (2010) 96, 500 505 ORIGINAL ARTICLE How repaired rotator cuff function influences Constant scoring D. Goutallier a,, J.-M. Postel a, C. Radier b, J. Bernageau
More informationTHE TENDONS OF THE supraspinatus, infraspinatus,
1162 ORIGINAL ARTICLE The Validity of the Lag Signs in Diagnosing Full-Thickness Tears of the Rotator Cuff: A Preliminary Investigation Caroline A. Miller, MSc, Gail A. Forrester, MSc, Jeremy S. Lewis,
More informationSupraspinatus tendon tears: comparison of US and MR arthrography with surgical correlation
Eur Radiol (2002) 12:1211 1217 DOI 10.1007/s00330-001-1183-3 MUSCULOSKELETAL Francesco S. Ferrari Simone Governi Francesca Burresi Francesco Vigni Paolo Stefani Supraspinatus tendon tears: comparison of
More information