Ultrasonographic findings of painful shoulders and correlation between physical examination and ultrasonographic rotator cuff tear

Abstract

The objectives of this study were to identify ultrasonographic (US) abnormalities and to compare physical examination with US findings, especially of rotator cuff abnormalities in patients with shoulder pain. A total of 120 patients with shoulder pain were prospectively studied. The physical examination of shoulders was performed as follows: (1) the area of tenderness; (2) the range of passive and active motion for abduction, forward flexion, external rotation, and internal rotation; (3) Neer and Hawkins's tests for shoulder impingement; and (4) maneuvers for determining the location of the tendon lesions. Transverse and longitudinal planes from the long head of the biceps, supraspinatus, infraspinatus, and subscapularis tendons, the subacromial-subdeltoid bursa, and the glenohumeral and acromioclavicular joints were included for US examination. The range of motion most affected by shoulder pain was abduction, followed by external rotation and forward flexion. The most frequent US finding was effusion in the long head of the biceps tendon. Among the rotator cuff tendons, supraspinatus was the most frequently involved. Physical examination had low sensitivity and specificity for the detection of tendon tear. US examination leads to an anatomical diagnosis of shoulder pain in many patients. Whether the US examination of the painful shoulder improves its treatment should be investigated.

Prevalence of the Rotator Cuff Tear Increases With Weakness in Hemiplegic Shoulder

“…However, there was no trend between the motor power of affected shoulder and shoulder pain or limitation of ROMs. Other previous studies did not reveal a definite relationship of RCT to HSP [9,37], either, suggesting that RCT may not be the main pathology of HSP. In addition, most degenerative RCTs were known to be asymptomatic [1] in the aged population; the RCT in hemiplegic shoulder might be pathophysiologically analogous to asymptomatic degenerative RCTs.…”

Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests

“…Therefore, the rotator cuff tear group included those studies where diagnostic accuracy was examined inclusive of any size of tear or classification system used. Three studies25 30 33 in the RCT category addressed full-thickness tears, one study39 addressed massive RCTs, and six studies41 42 46 52–54 addressed RCT's regardless of size or classification. Of the 10 RCT studies, five used tests designed to test specific, individual muscles of the rotator cuff.…”

Effect of subacromial sodium hyaluronate injection on rotator cuff disease: A double-blind placebo-controlled clinical trial

“…Tendinitis was diagnosed when the tendon lost its echogenicity and became diffusely hypoechoic. [171819] Dynamic evaluation of abduction was performed by observing the supraspinatus tendon and bursa longitudinally as they retract deep to the coracoacromial ligament. Bunching of tissue or buckling of the ligament correlated with impingement.…”

“…The diagnosis of a partial rotator cuff tear was made when the hypoechoic or bursal herniation did not cross the full width of the tendon. [171819]…”