MSKSONO.COM
Biceps Tendon
Transverse, at the
level of the Lesser
Tuberocity
Biceps Tendon at
the Rotator Cuff
Interval
Transverse
Subscapularis
Tendon Proximal
to its insertion
Longitudinal
Subscapularis
Tendon.
Proximal
Subscapularis
view, level of
Coracroid Process
Transverse
Supraspinauts
Tendon; bicep in
vew on left.
Long Biceps at
Interval, from here
scan posteriorly to
find Supraspinatus
Long
Supraspinatus
Tendon; inserts at
Greater Tuberocity
Supraspinatus
Tendon; Probe
angled to match
insertion angle
Infraspinatus
Tendon Long
insert to posterior
Greater Tuberocity
Infraspinatus at
the posterior
Humeral Head.
Long axis
Infraspinatus
proximal,
longitudinal
Infraspinatus
Muscle long axis
over Scapula
Lateral Shoulder
dynamic
Abduction Study
AC Joint
Longitudinal
Routine Shoulder Images
Routine Shoulder Exam
While there are many documented ways to examine the shoulder, I like to take
my methods from multiple authors as listed under the references tab.  The
shoulder exam is likely the most common application of ultrasound in MSK.
Articles about the shoulder exam can be dated back as far as the late 1980's and
much of those techniques are still in practice, only the technology has improved.
One of my favorite all time articles about the shoulder was written by Sharlene
Teefey M.D. and William Middleton back in 1999 under the "Radiologic Clinics of
North America" July, volume 37 no.4.  This article demonstrates a proper
shoulder evaluation in my opinion, and the basics are to be performed each and
every exam, with out taking shortcuts.  While this article is relatively older, the
principle scanning method is highly reliable in detecting Rotator Cuff pathology.
Rotator Cuff Structures:
  • Biceps Brachii Long Head
  • Subscapularis Tendon
  • Rotator Cuff Interval
  • Supraspinatus Tendon
  • Infraspinaus Tendon
  • Teres Minor
Other Structures of interest:
  • Pectoralis Major
  • Transverse Ligament
  • Coracoacromial Ligament
  • Coracohumoral Ligament
  • Posterior Glenoid Labrum
  • Inferior Glenoid Labrum
  • Suprascapular Nerve and Artery
  • Suprascapular Notch
  • Acromioclavicular Joint
  • Subacromial/Subdeltoid Bursa
Avulsion of the superior Lesser
Tuberocity surface. I
 Normal image of Rotator Cuff Interval.
 Normal image of Rotator Cuff Interval.
Counter
Sample Shoulder Page....MSKSONO.COM under construction
Basic Shoulder Examination
Please click on the images below to elarge
Diagnostic Shoulder findings include (but not limited to):
  • Biceps Tenosynovitis, rupture (total, partial thickness or intrasubstance)
  • Rotator cuff tear (total, partial thickness or intrasubstance),
    calcification enthesopathy, Tenonosis, Tendonitis,
  • Subacromial/Subdeltoid bursitis, thickening, rupture, calcification
  • Impingement and or adhesive capsulitis studies with dynamic maneuvers
  • Posterior Glenoid labrum studies with dynamic studies.
  • Spinoglenoid notch for Suprascapular Nerve impingement by paralabral
    cyst.
  • Atrophy/hypertrophy assessment of Teres Minor, Infrapsinatus, and
    Supraspinatus musculature.
  • Acromioclavicular Joint studies including dynamic maneuvers showing joint
    widening/dislocation and intra-articular debris, and Doppler assessment for
    inflammatory pathology
  • Study of the ligaments of the Rotator Cuff Complex (i.e. Coracohumeral,
    Coracoacromial)
  • When in doubt, assess the contra-lateral extremity for comparison.