Ultrasonography for Diagnosing Sports-Related Shoulder Pain

Seok Song Hyun

doi:10.4055/jkoa.2019.54.5.384

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Hyun: Ultrasonography for Diagnosing Sports-Related Shoulder Pain

Original Article

J Korean Orthop Assoc 2019;54(5):384-392.

DOI: https://doi.org/10.4055/jkoa.2019.54.5.384

Ultrasonography for Diagnosing Sports-Related Shoulder Pain

Seok Song Hyun, M.D., Ph.D.

Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to: Hyun Seok Song, M.D., Ph.D. Department of Orthopedic Surgery, The Catholic University of Korea, Eunpyeong St. Mary’s Hospital, 1021 Tongil-ro, Eunpyeong-gu, Seoul 03312, Korea TEL: +82-2-2030-4628 FAX: +82-2-2030-4629 E-mail: hssongmd@hanmail.net ORCID: https://orcid.org/0000-0002-7844-2293

Received 15 August 20181 March 2019 Accepted 12 June 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ultrasonography is used for making the diagnosis and treatment decisions for those patients who complain of shoulder pain related with sports activity. Ultrasonography is especially helpful for diagnosing issues with the rotator cuff, the long head of biceps tendon and the acromio-clavicular joint. The medical decisions about shoulder pain can be promptly made when portable ultrasonography is used in the field of sports.

Keywords: sports injury, shoulder, ultrasonography

References

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Figure 1.

Ultrasonography of the short axis of the SSP showing hyperechoic fluid in the tear (arrow). RT, right; SSP, supraspinatus.

Figure 2.

Ultrasonography of the long axis of the SSP showing a medially retracted torn edge (arrow). RT, right; SSP, supraspinatus.

Figure 3.

Ultrasonography of the short axis of the SPP showing cartilage interface sign’ with the hyperechoic line of the articular cartilage (arrows). LT, left; SSP, supraspinatus.

Figure 4.

Ultrasonography of the long axis of the supraspinatus showing the ‘peribursal sagging sign’ (between two crosses) at the lateral corner of the greater tuberosity.

Figure 5.

Partial thickness articular side supraspinatus tear. (A) Ultrasonography of the short axis of the supraspinatus showing the partial thickness tear with a hypoechoic defect (arrow). (B) Arthroscopic photo showing a partial thickness tear (arrow).

Figure 6.

Ultrasonography of the long axis of the SSC showing hypoechoic defects (arrows). RT, right; SSC, subscapularis.

Figure 7.

Ultrasonography of the long axis of the SSC showing a normal insertion pattern (LT) (A) and the parallel pattern of tear (RT) (B). Dotted lines show the fiber pattern. LT, left; RT, right; SSC, subscapularis.

Figure 8.

Ultrasonography of the short axis of the long head of biceps tendon showing normal width (LT) (A) and narrow width (RT) (arrow) (B) of the bicipital groove. LT, left; RT, right.

Figure 9.

Ultrasonography of the short axis of the long head of biceps tendon showing normal diameter (RT) (A) and the swollen tendon (LT) (arrows) (B). RT, right; LT, left.

Figure 10.

Injury of the A-C JT. (A) Ultrasonography of the A-C JT showing a widened joint space (between two crosses) and fluid (arrow). (B) Intraoperative photo showing a torn acromio-clavicular ligament (arrow). RT, right; A-C JT, acromio-clavicular joint.

Figure 11.

Injury of the anterior labrum. (A) Position of the probe lying on the anterior shoulder (in the supine position). (B) Ultrasonography of the axial plane of the ANT shoulder showing a torn anteroinferior labrum (Bankart lesion) (arrow). H, humeral head; G, glenoid; LT, left; ANT, anterior.

Table 1.

Reliability of Ultrasonography for the Cuff Tear

Study	Sensitivity	Specificity	Accuracy
	(%)	(%)	(%)
Full-thickness tear
Mack et al.¹⁴⁾	91	100	94
Soble et al.¹¹⁾	93	73	83
Farin et al.¹³⁾	81	95	90
Teefey et al.⁸⁾	100	85	96
Middleton et al.⁹⁾	93	83	87
Iannotti et al.¹²⁾	88	80	80
Partial-thickness tear
van Holsbeeck et al.¹⁰⁾	93	94	94
Teefey et al.⁸⁾	67	85	77

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