[Differential diagnosis of pathological and pseudo-pathological shoulder. Clinico-ultrasonographic findings]

Clinical examination for rotator cuff tears is rarely conclusive and very difficult is the differential diagnosis with lesions of the axillary nerve. In a little hospital we chose to use first non invasive and cheaper tools for this diagnosis. 24 patients were first evaluated by a physiatric MD, and radiological and ultrasound studies were then performed. Ultrasonography (US) was done with a high frequency probe (7.5 MHz). More than 85% of our patients had, in this way a quick, cheap and non invasive diagnosis, and moreover a quick rehabilitation treatment. Only 3 patients were later studied invasively by arthrography or electromyography with needle, their treatment started later. In 3 patients US demonstrates a normal rotator cuff, and so a diagnosis of nervous lesion. Four patients had a complete large tear of the rotator cuff. In 14 patients US shows small or partial tear. Our non invasive diagnosis was quick, cheap and therapy started earlier with better final results.