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Sonographic Evaluation of Shoulder Arthroplasty

Carolyn M. Sofka1 and Ronald S. Adler

1 Both authors: Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th St., New York, NY 10021.



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  		Fig. 1. —76-year-old woman with intact supraspinatus tendon. Longitudinal extended field-of-view sonogram shows intact tendon fibers (arrows) inserting onto greater tuberosity.

 


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  		Fig. 2. —51-year-old woman with insertional tear of supraspinatus tendon. Longitudinal extended field-of-view sonogram shows focal tendinous discontinuity at insertion (black arrow). Note characteristic reverberation artifact (white arrow) from metallic component of prosthesis.

 


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  		Fig. 3A. —62-year-old woman with complete tear of subspinatus tendon. Longitudinal extended field-of-view sonogram shows anechoic fluid and no definable tendon at lesser tuberosity (straight arrow). Reverberation from metallic prosthesis (curved arrow) can be seen. Magnified view of area outlined by white rectangle is shown in B.

 


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  		Fig. 3B. —62-year-old woman with complete tear of subspinatus tendon. Magnified view shows area outlined by white rectangle in A in greater detail.

 


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  		Fig. 4. —78-year-old woman with biceps tendinosis and tenosynovitis. Axial power Doppler sonogram shows thickened, enlarged biceps tendon, which is consistent with tendinosis, with intrasubstance split (straight arrow). Hypoechoic tendon sheath effusion surrounds tendon (curved arrow). Areas of color flow are indicative of inflammation.

 


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  		Fig. 5. —74-year-old man with atrophy of teres minor muscle. Sonogram shows diffuse increased echogenicity of teres minor muscle resulting from fatty infiltration (arrows). Compare echo pattern of teres minor muscle with normal hypoechoic appearance of infraspinatus muscle, which is located superior to teres minor muscle.

 


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  		Fig. 6A. —68-year-old man with metallic wear of glenoid compartment that was confirmed at revision arthroplasty Longitudinal sonograms show characteristic reverberation artifact from metal (curved arrow, A) at posterior aspect of glenohumeral joint. Note punctate metallic fragments (straight arrows) scattered throughout posterior aspect of joint.

 


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  		Fig. 6B. —68-year-old man with metallic wear of glenoid compartment that was confirmed at revision arthroplasty Longitudinal sonograms show characteristic reverberation artifact from metal (curved arrow, A) at posterior aspect of glenohumeral joint. Note punctate metallic fragments (straight arrows) scattered throughout posterior aspect of joint.

 


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  		Fig. 7A. —56-year-old man with partial articular-sided tear of supraspinatus tendon. Longitudinal gray-scale sonogram shows articular-sided tear (arrow) of supraspinatus tendon.

 


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  		Fig. 7B. —56-year-old man with partial articular-sided tear of supraspinatus tendon. Sonogram obtained using tissue harmonics shows improved contrast between irregular hypoechoic tear and adjacent soft tissues (arrow) compared to A.

 

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