EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Shoulder

Abstract

In this dynamic protocol, ultrasound examination of the shoulder using different maneuvers is described for several/relevant shoulder problems. Scanning videos are coupled with real-time patient examination videos for better understanding. The authors believe that this practical guide prepared by an international consensus of several experts (EURO-MUSCULUS: European Musculoskeletal Ultrasound Study Group and USPRM: Ultrasound Study Group of ISPRM [International Society of Physical and Rehabilitation Medicine]) will help musculoskeletal physicians perform a better and uniform/standard approach.

Clinical/Sonographic Assessment and Management of Calcific Tendinopathy of the Shoulder: A Narrative Review

“…Night rest is severely compromised and the patient is unable to lie on the affected side. In some patients, the sonographic visualization of intrabursal migration of calcific fragments can be challenging; dynamic scanning with gentle active/passive movements of the shoulder can be necessary to promptly identify “bright spots” floating within the bursal cavity [ 23 ].…”

From Histoanatomy to Sonography in Myofascial Pain Syndrome

“…Unlike other musculoskeletal structures/pathologies [38][39][40][41][42][43][44][45][46][47] for which US examination protocols have been defined, it is not always easy to precisely define all the previously mentioned US features of the MTrPs in clinical practice. First and foremost, different phases of the syndrome and/or its several subtypes would be responsible for the variable/challenging clinical and US findings.…”

Assessing/Imaging the Subcoracoid Space: From Anatomy to Dynamic Sonography

“…Due to the anatomical proximity with the axillary neurovascular bundle, the bursal wall can also display intermittent pulsations (online supplemental Video 2). 13 Lastly, dynamic imaging can be useful to accurately define the sono‐histological pattern of the subcoracoid bursa for example, hypertrophic bursitis with synovial proliferations floating inside the cavity, exudative bursitis with a thin wall (online supplemental Videos 1, 2) or bursitis with an intra‐bursal loose body 2 . In the latter case, subsynovial connective tissue metaplasia can lead to proliferation of cartilage within the synovial membrane of the subcoracoid bursa (ie, synovial chondromatosis) generating an intra‐bursal loose body.…”

“…With the upper limb adducted to the trunk, the forearm supinated, the elbow flexed to 90° and the shoulder extended (simplified Crass position) 17 ; active/passive flexion and extension of the glenohumeral joint can be performed. The probe is positioned in an oblique transverse plane to dynamically evaluate the proximal segment of the LHBT inside the rotator interval 2 …”

“…Shoulder disorders are commonplace in musculoskeletal medicine. In the pertinent literature, static 1 and dynamic 2 ultrasound (US) imaging protocols have been described to promptly optimize the diagnosis and guided interventions 3 in their management. Herewith, it is quite challenging to scan the subcoracoid space during shoulder US examination.…”