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Does Extended-Field-of-View Sonography Improve Interrater Reliability for the Detection of Rotator Cuff Muscle Atrophy?

Eoin C. Kavanagh1,2, George Koulouris1, Laurence Parker1, William B. Morrison1, Diane Bergin1, Adam C. Zoga1, John A. Dlugosz1 and Levon N. Nazarian1

1 Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA.
2 Present address: Division of Musculoskeletal Radiology, Department of Radiology, University of Pittsburgh Medical Centre, 200 Lothrop St., Pittsburgh, PA 15213.


Figure 1
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  		Fig. 1 —Extended-field-of-view (EFOV) sonographic technique for evaluation of supraspinatus and infraspinatus muscles in 36-year-old male volunteer. Static EFOV sonographic image created from Figure S1, video clips available as supplemental data at www.ajronline.org, shows supraspinatus (S), infraspinatus (I), and trapezius (T) muscles. There is acoustic shadowing from scapular spine (asterisk).

 

Figure 2
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  		Fig. 2A —42-year-old man with shoulder pain. Conventional longitudinal image of supraspinatus muscle (S), which was graded as normal, shows pinnate pattern of hypoechoic muscle fibers separated by hyperechoic fibroadipose septa (arrowhead). Supraspinatus muscle is comparable in echogenicity to overlying trapezius muscle (T).

 

Figure 3
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  		Fig. 2B —42-year-old man with shoulder pain. Conventional longitudinal image of infraspinatus muscle (I) shows pennate pattern of normal muscle fibers (arrowhead).

 

Figure 4
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  		Fig. 3 —37-year-old woman with shoulder pain. Extended-field-of-view sonogram shows supraspinatus (S) and infraspinatus (I) muscles, which were graded as normal. Note acoustic shadowing from scapular spine (asterisk). Muscle echogenicity is compared with overlying trapezius muscle (T).

 

Figure 5
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  		Fig. 4 —54-year-old man with shoulder pain. Conventional longitudinal image of supraspinatus muscle (S) shows increased echogenicity and poor definition of normal pennate pattern of muscle fibers compared with overlying trapezius muscle (T). These findings are consistent with fatty muscle atrophy of supraspinatus muscle.

 

Figure 6
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  		Fig. 5 —67-year-old woman with shoulder pain. Conventional longitudinal image of infraspinatus muscle (I) shows increased echogenicity, decreased muscle volume, and loss of normal pennate pattern of muscle fibers. These findings are consistent with fatty muscle atrophy of infraspinatus muscle.

 

Figure 7
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  		Fig. 6 —54-year-old man with shoulder pain. Extended-field-of-view sonogram shows supraspinatus muscle (S) graded as normal and fatty atrophy of infraspinatus muscle (I). Note acoustic shadowing from scapular spine (asterisk). T = trapezius muscle.

 

Figure 8
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  		Fig. 7 —57-year-old woman with shoulder pain. Extended-field-of-view (EFOV) sonogram shows supraspinatus (S) and infraspinatus (I) muscles, which were graded as atrophy. Note acoustic shadowing from scapular spine (asterisk). Also shown is a stairstep artifact (arrows) from EFOV technique.

 

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