AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bureau, N. J.
Right arrow Articles by Brassard, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bureau, N. J.
Right arrow Articles by Brassard, P.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Hotlight (NEW!)
Right arrow
What's Hotlight?

Dynamic Sonography Evaluation of Shoulder Impingement Syndrome

Nathalie J. Bureau1, Marc Beauchamp2,3, Etienne Cardinal1 and Paul Brassard4

1 Radiology Department, CH Université de Montréal, Hôpital Saint-Luc, 1058 Saint-Denis St., Montreal, QC, H2X 3J4 Canada.
2 Orthopedic Department, CH Université de Montréal, Hôtel Dieu de Montréal, Montreal, QC, H2W 1T8 Canada.
3 Present address: Médiclub, Montreal QC, H3S 2W1 Canada.
4 Division of Clinical Epidemiology, McGill University Health Center, Royal Victoria Hospital, Montreal, QC, H3A 1A1 Canada.


Figure 1
View larger version (97K):

[in a new window]
  		Fig. 1A —Sonograms of normal shoulder and shoulders with impingement. (See also Figs. S1A-S1C, videos, in supplemental data online.) 37-year-old man with normal dynamic sonography evaluation. Coronal sonography view of left asymptomatic shoulder, during active elevation of arm halfway between flexion and abduction with hand in pronation, shows unobstructed passage of greater tuberosity (T) of humeral head and supraspinatus tendon (S) underneath acromion (A).

 

Figure 2
View larger version (107K):

[in a new window]
  		Fig. 1B —Sonograms of normal shoulder and shoulders with impingement. (See also Figs. S1A-S1C, videos, in supplemental data online.) 49-year-old man with soft-tissue impingement during dynamic sonography evaluation of shoulder. Coronal sonography view of left shoulder with subacromial impingement, during active elevation of arm halfway between flexion and abduction with hand in pronation, shows pooling of fluid in lateral aspect of subacromial-subdeltoid bursa (arrow) and mild impingement of supraspinatus tendon (arrowhead) as greater tuberosity (T) of humeral head approximates anterior one third of acromion (A). Note that humeral head remains in anatomic position, below acromion.

 

Figure 3
View larger version (103K):

[in a new window]
  		Fig. 1C —Sonograms of normal shoulder and shoulders with impingement. (See also Figs. S1A-S1C, videos, in supplemental data online.) 43-year-old man with upward migration of humeral head during dynamic sonography evaluation of shoulder. Coronal sonography view of left shoulder with shoulder impingement syndrome, during active elevation of arm halfway between flexion and abduction with hand in pronation, shows abnormal upward migration of humeral head (H) in regard to acromion (A), preventing its passage underneath acromion. There is mild distention of subacromial bursa (arrowhead). S = supraspinatus tendon.

 

Figure 4
View larger version (123K):

[in a new window]
  		Fig. 2 —Subjective drawing (not based on cadaveric model) of normal dynamic shoulder evaluation. Drawing (coronal plane, cut section) of left shoulder during active elevation of arm halfway between flexion and abduction with hand in pronation shows normal relationships between acromion (A), greater tuberosity (T) of humeral head, and intervening soft tissues—namely, supraspinatus tendon (S) and subacromial-subdeltoid bursa (arrow). D = deltoid muscle.

 

Figure 5
View larger version (122K):

[in a new window]
  		Fig. 3 —Subjective drawing (not based on cadaveric model) of subacromial impingement with soft-tissue involvement. Drawing (coronal plane, cut section) of left shoulder during active elevation of arm halfway between flexion and abduction with hand in pronation explicitly depicts pooling of fluid in lateral aspect of subacromial-subdeltoid bursa (arrow) and alteration of normally convex surface of supraspinatus tendon (arrowhead) as arm is elevated. Supraspinatus tendon is not always involved in grade 2 subacromial impingement. There is also evidence of supraspinatus tendinosis and inflammatory changes in bursa.

 

Figure 6
View larger version (119K):

[in a new window]
  		Fig. 4 —Subjective drawing (not based on cadaveric model) of subacromial impingement with upward migration of humeral head. Drawing (coronal plane, cut section) of left shoulder during active elevation of arm halfway between flexion and abduction with hand in pronation shows upward migration of humeral head in relation to glenoid cavity, which prevents passage of greater tuberosity (T) and soft-tissue structures of supraspinatus outlet beneath acromion.

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Roentgen Ray Society.