Rotator cuff disease is a degenerative disorder that is a common, costly, and often debilitating, ranging in severity from partial thickness tear, which may cause pain, to total rupture, leading to loss in function. In current clinical practice, treatment decisions are frequently made through subjective assessment of pain and range of motion combined with qualitative assessment of x-ray images, magnetic resonance images (MRI), or ultrasound images. Treatment of disease may include physical therapy, surgery, or a combination of both. Often, the final determination of the best course of action is at the discretion of the clinician, and is based on personal experience as opposed to quantitative standards. v ACKNOWLEDGEMENTS I would first like to acknowledge my advisor, Dr. David Kwartowitz for providing assistance and direction throughout my graduate research. I would also like to thank my committee members Dr. Delphine Dean and Dr. Melinda Harman for their insight and guidance.

The work showed significant ([Formula: see text]) decrease in radiation dose with use of image guidance methods at the expense of a modest increase in procedure time. This study lays the groundwork for further exploration of image guidance applications in pediatric cardiology.

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