Sonographic study of painful shoulder

Area of Science:

• Musculoskeletal imaging
• Rheumatology
• Diagnostic ultrasound

Background:

• Shoulder pain is a common complaint with diverse etiologies.
• Accurate diagnosis is crucial for effective management of shoulder conditions.
• Sonography offers a non-invasive approach to visualize shoulder structures.

Purpose of the Study:

• To sonographically identify the site and nature of shoulder alterations in patients with shoulder pain.
• To evaluate the diagnostic accuracy of sonography compared to physical examination.

Main Methods:

• Sonographic examinations were performed by two experienced rheumatologists on 528 shoulders of 425 patients with shoulder pain and 198 control subjects.
• Ultrasound investigations included tendons (long head of biceps, supraspinatus, infraspinatus, subscapularis), joints (acromioclavicular, glenohumeral), bursae, and calcifications.
• A physical examination with specific tests was conducted prior to sonography.

Main Results:

• Sonographic alterations were detected in 94.1% of patients.
• The supraspinatus tendon (64.6%), acromioclavicular joint (51.5%), and long head of biceps tendon (48.1%) were most frequently involved.
• Sonography demonstrated high sensitivity and specificity compared to physical examination, with significant differences noted versus controls.

Conclusions:

• Sonography accurately assesses shoulder anatomic structures, identifying the site and type of changes in painful shoulders.
• The technique's high sensitivity, specificity, non-invasiveness, and low cost support its routine use in rheumatological practice.