Detection and quantification of glenohumeral joint effusion: reliability of ultrasound

Abstract

Objectives To evaluate reliability of ultrasound for detection and quantification of glenohumeral joint effusion. Methods With institutional review board approval and informed consent ultrasound of 30 consecutive patients before and after MR arthrography of the shoulder was performed. Presence and width of any anechoic collection was noted within various locations (biceps tendon sheath, subscapular recess (neutral position and internal rotation), posterior glenohumeral joint recess (neutral position and external rotation)). Injected fluid (8-12 ml) into the glenohumeral joint served as gold-standard. Widths of anechoic collections were correlated (Spearman rank correlation) with injected fluid. Results Glenohumeral anechoic collection was consistently seen in the posterior glenohumeral joint recess with the arm in external rotation (100%, 30/30), and in the biceps tendon sheath (97%, 29/30). Ultrasound was not sensitive at other locations (7%-17%). Mean width in anterior-posterior direction of anechoic collection in the posterior glenohumeral joint recess was 7 mm (range: 3-18 mm), 2 mm (range: 1-7 mm) in the biceps tendon sheath. Significant correlation (R=0.390, p=0.033) was found between width of anechoic collection and injected fluid in the posterior glenohumeral joint recess. Conclusions Glenohumeral joint effusion can be detected and quantified most reliably in the posterior glenohumeral joint recess with the arm in external rotation.

Development and Reliability of the Joint Tissue Activity and Damage Examination for Quantitation of Structural Abnormalities by Musculoskeletal Ultrasound in Hemophilic Joints

“…Another limitation was the lack of joint effusion assessments, since joints were imaged at patients’ baselines with a paucity of effusions present. Although even small volume joint effusions are easily detected by musculoskeletal US, the accuracy of effusion assessments in hemophilia requires formal study. Also, intra‐operator reliability was not assessed because we thought that the second assessment would require several weeks to pass to limit memorization of initial findings.…”

Intraarticular Local Anesthesia: Can It Reduce Pain Related to MR or CT Arthrography of the Shoulder?

“…Fox and colleagues injected 12 mL of contrast mixture containing 10 mL of 0.5% ropivacaine (volume and amount injected were 6 mL and 30 mg, respectively), whereas we injected approximately 13 mL of contrast agent mixed with 1.5 mL of 2% mepivacaine (volume and amount injected were 0.9 mL and 18 mg, respectively). In numerous previous studies [8,[12][13][14][15][16], 0.5-1.3 mL of 2% mepivacaine, which was the actual intraarticularly injected dose, was used in MR arthrography of the shoulder. The intraarticularly injected dose of mepivacaine used in this study was determined on the basis of these previous studies.…”

Pitfalls in Imaging of Musculoskeletal Infections

“…3 Ultrasonography helps detect effusion in the hip and shoulder joints that may difficult to discern by physical examination. 4,5 It helps assess the presence and extent of infected fluid in the superficial synovial cyst, bursa, and tendon sheath. Although it has limited value in the evaluation of bone diseases, ultrasonography can detect subperiosteal abscesses in osteomyelitis of children.…”