Imaging Algorithms for Evaluating Suspected Rotator Cuff Disease: Society of Radiologists in Ultrasound Consensus Conference Statement

Nazarian, Levon N.; Jacobson, Jon A.; Benson, Carol B.; Bancroft, Laura W.; Bedi, Asheesh; McShane, John M.; Miller, Theodore T.; Parker, Laurence; Smith, Jay; Steinbach, Lynne S.; Teefey, Sharlene A.; Thiele, Ralf; Tuite, Michael J.; Wise, James T.F.; Yamaguchi, Ken

doi:10.1148/radiol.13121947

Cited by 99 publications

(46 citation statements)

References 46 publications

(52 reference statements)

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“…The the most common indication for shoulder US in patients older than 40 years (36). The spectrum of SST anomalies evaluated with US includes SST tear (full-and partial-thickness tears), SST tendinopathy (ie, tendinosis and tendinitis), subacromial impingement, and calcific tendinitis.…”

Section: Common Indications and Diseasesmentioning

confidence: 99%

Comprehensive Shoulder US Examination: A Standardized Approach with Multimodality Correlation for Common Shoulder Disease

Lee¹,

Sheehan²,

Orwin³

et al. 2016

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1Shoulder pain is one of the most common musculoskeletal conditions encountered in primary care and specialty orthopedic clinic settings. Although magnetic resonance (MR) imaging is typically the modality of choice for evaluating the soft-tissue structures of the shoulder, ultrasonography (US) is becoming an important complementary imaging tool in the evaluation of superficial softtissue structures such as the rotator cuff, subacromial-subdeltoid bursa, and biceps tendon. The advantages of US driving its recent increased use include low cost, accessibility, and capability for realtime high-resolution imaging that enables dynamic assessment and needle guidance. As more radiologists are considering incorporating shoulder US into their practices, the development of a standardized approach to performing shoulder US should be a priority to facilitate the delivery of high-quality patient care. Familiarity with and comfort in performing a standardized shoulder US examination, as well as knowledge of the types of anomalies that can be evaluated well with US, will enhance the expertise of those working in musculoskeletal radiology practices and add value in the form of increased patient and health care provider satisfaction. This review describes the utility and benefits of shoulder US as a tool that complements MR imaging in the assessment of shoulder pain. A standardized approach to the shoulder US examination is also described, with a review of the basic technique of this examination, normal anatomy of the shoulder, common indications for shoulder US, and characteristic US findings of common shoulder diseases-with select MR imaging and arthroscopic correlation. Abbreviations: AC = acromioclavicular, IST = infraspinatus tendon, LHBT = long head of the biceps tendon, RC = rotator cuff, SASD = subacromial-subdeltoid, SST = supraspinatus tendon, SubST = subscapularis tendon

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Section: Common Indications and Diseasesmentioning

confidence: 99%

Comprehensive Shoulder US Examination: A Standardized Approach with Multimodality Correlation for Common Shoulder Disease

Lee¹,

Sheehan²,

Orwin³

et al. 2016

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“…The latter is important in guiding additional cross-sectional imaging toward MRI (for patients in whom little metallic hardware has been used) or toward CTA (for patients with more metallic hardware). Ultrasonography is an extremely valuable cross-sectional imaging alternative to the evaluation of the rotator cuff tendons 3 and is discussed later; but, because ultrasonography does not provide a global view of the post-operative shoulder, it is performed less commonly than MRI or MRA for patients with shoulder issues at our institution (Johns Hopkins University School of Medicine, Baltimore, MD) ( Figure 1). …”

Section: Imaging Approachmentioning

confidence: 99%

Complications of rotator cuff surgery—the role of post-operative imaging in patient care

Thakkar¹,

Thakkar²,

Srikumaran³

et al. 2014

BJR

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When pain or disability occurs after rotator cuff surgery, post-operative imaging is frequently performed. Post-operative complications and expected post-operative imaging findings in the shoulder are presented, with a focus on MRI, MR arthrography (MRA) and CT arthrography. MR and CT techniques are available to reduce image degradation secondary to surgical distortions of native anatomy and implant-related artefacts and to define complications after rotator cuff surgery. A useful approach to image the shoulder after surgery is the standard radiography, followed by MRI/MRA for patients with low "metal presence" and CT for patients who have a higher metal presence. However, for the assessment of patients who have undergone surgery for rotator cuff injuries, imaging findings should always be correlated with the clinical presentation because post-operative imaging abnormalities do not necessarily correlate with symptoms.The complexity of the anatomy and function of the rotator cuff makes the rotator cuff tendons vulnerable to considerable morbidity, often necessitating surgical intervention. Optimal management of rotator cuff abnormalities depends on a variety of factors, such as the presence and severity of an impingement, the degree of tendon damage and individual functional demands.1 The goals of rotator cuff surgery are to reduce pain, while simultaneously improving the function. The latter is accomplished by two main types of surgical procedures: (1) subacromial decompression surgery alone, typically with an acromioplasty and/or Mumford procedure (distal clavicular resection); and (2) repair of the rotator cuff tear (open or arthroscopic), which is almost always accompanied by a subacromial decompression.Post-operative imaging is performed when pain or disability occurs after a surgical procedure. Often, however, postoperative imaging is degraded by surgical distortions of the native anatomy and metallic artefacts related to implants. Nevertheless, it is imperative that clinicians have an accurate anatomical delineation of the operative site. It is also important for the radiologist to accurately diagnose complications that might occur after rotator cuff surgery to guide optimal treatment. Mansat et al 2 examined 40 articles reporting the results of open rotator cuff repairs and determined that the overall mean complication rate was 10.5%.The article addresses complications that occur after rotator cuff surgery and expected post-operative imaging findings, with a focus on MRI, MR arthrography (MRA) and CT arthrography (CTA). Because not all post-operative imaging findings result in disability or pain for the patient, we also emphasize our approach and experience regarding how best to define imaging abnormalities after rotator cuff surgery. IMAGING APPROACHA protocol for the imaging of the post-operative shoulder always begins with radiography of the shoulder. The purpose of the radiograph is not only to detect obvious osseous complications, but also to identify the type of surgical procedure performed ...

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“…Kas-iskelet sisteminde temel inceleme direkt radyolojik incelemedir. Özellikle, travma hikayesi olmayan ve >40 yaş üzerindeki hastalar ile travma hikayesi olan tüm yaş guruplarında incelemeye direkt grafi ile başlanmalıdır [2].…”

Section: Rotator Kılıf Yırtığı Ve Görüntülemeunclassified

“…Rotator kılıf yırtığı %65-70 olguda görülür ve görülme sıklığı yaş ile artar. İleri yaş grubunda tam kat RK yırtıklarında hastaların bir kıs-mı asemptomatik olabilir ve >70 yaş bireylerin %50'den fazlasında RK yırtığı vardır [1][2][3].Rotator kılıf lezyonları geniş bir spektrumda bir dizi patolojik değişiklikten oluşur ve spektrumun bir ucunda RK inflamasyonu, diğer ucunda ise kılıfın bir veya daha fazla tendonunda tam kat kalınlık yırtığı mevcuttur [3]. Rotator kılıf lezyonlarının erken tanısı yalnızca tedavi programını kolaylaştırmaz, aynı zamanda hastanın ağrı ile giderek artan hareket kısıtlılığı nedeni ile oluşan yaşam kalitesindeki olumsuzluğu da azaltabilir.…”

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Rotator Kılıf: Patolojik Değişiklikler

Arkun¹

2014

Trd Sem

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Omuz ağrısı kas-iskelet sistemine ait klinik yakınmalar arasında üçüncü sıklıktadır ve yetişkinlerin %7-26'sında görülür. Omuz ağrısına yol açan nedenler arasında görülme sıklığına göre rotator kılıf (RK) lezyonları, donuk omuz, instabilite ve osteoartrit önde gelen nedenlerdir. Rotator kılıf yırtığı %65-70 olguda görülür ve görülme sıklığı yaş ile artar. İleri yaş grubunda tam kat RK yırtıklarında hastaların bir kıs-mı asemptomatik olabilir ve >70 yaş bireylerin %50'den fazlasında RK yırtığı vardır [1][2][3].Rotator kılıf lezyonları geniş bir spektrumda bir dizi patolojik değişiklikten oluşur ve spektrumun bir ucunda RK inflamasyonu, diğer ucunda ise kılıfın bir veya daha fazla tendonunda tam kat kalınlık yırtığı mevcuttur [3]. Rotator kılıf lezyonlarının erken tanısı yalnızca tedavi programını kolaylaştırmaz, aynı zamanda hastanın ağrı ile giderek artan hareket kısıtlılığı nedeni ile oluşan yaşam kalitesindeki olumsuzluğu da azaltabilir. Omuz patolojilerinin tanısında direkt radyolojik inceleme, ultrason (US) ve değişik tekniklerin kullanıldığı MR gö-rüntüleme önemli bilgiler veren yöntemlerdir.

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Imaging Algorithms for Evaluating Suspected Rotator Cuff Disease: Society of Radiologists in Ultrasound Consensus Conference Statement

Cited by 99 publications

References 46 publications

Comprehensive Shoulder US Examination: A Standardized Approach with Multimodality Correlation for Common Shoulder Disease

Comprehensive Shoulder US Examination: A Standardized Approach with Multimodality Correlation for Common Shoulder Disease

Complications of rotator cuff surgery—the role of post-operative imaging in patient care

Rotator Kılıf: Patolojik Değişiklikler

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