[Possibilities of diagnostic sonography in assessment of instability of the shoulder joint].
In a prospective study we evaluated diagnostic ultrasound investigation for shoulder instabilities. We measured the passive antero-posterior translation in 150 healthy persons in relation to the dorsal glenoid as well as the inferior subluxation in relation to the acromion. After establishing these normative data, we examined 23 patients with anterior unidirectional instabilities and 34 with multidirectional instabilities by ultrasound. Our results showed that the dorsal humeral head circumference of a normal joint is located about 8 to 10 mm dorsally to the glenoid. In the control group with non-injured shoulder is significantly higher as in the nondominant shoulder (p less than 0.01). Patients with anterior instabilities showed a highly significant increase of anterior translation in the injured shoulder (p less than 0.0001). In comparison with the control group there is a highly significant increase of downward subluxation under load in patients with multidirectional instabilities (p less than 0.001). In patients with multidirectional instabilities, there is also a significant increase of spontaneous downward subluxation of the dominant shoulder (p less than 0.01). In habitual or voluntary dislocations the relation of the humeral head to the glenoid can be judged staticly and dynamically. Secondary signs of dislocation (Hill-Sachs lesions, joint effusion) are evident. 13 patients of a total number of 22 patients we operated on, had bony or cartilaginous Hill-Sachs lesion. The specificity of preoperative ultrasound in detecting these Hill-Sachs lesions was 100% and the sensitivity was 89%.
Jerosch
J
J
Orthopädische Klinik und Poliklinik, Heinrich-Heine-Universität, Düsseldorf.
Goertzen
M
M
Marquardt
M
M
D000293:Adolescent; D000328:Adult; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010865:Pilot Projects; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging*; D012785:Shoulder Joint / Q000000981:diagnostic imaging*; D014463:Ultrasonography
Uber die Möglichkeiten der diagnostischen Sonographie bei der Beurteilung von Instabilitäten des Schultergelenkes.