title: Detection and quantification of glenohumeral joint effusion: reliability of ultrasound.
abstract: OBJECTIVE
  To evaluate reliability of ultrasound for detection and quantification of glenohumeral joint effusion.
  
  
  METHODS
  With institutional review board approval and informed consent ultrasound of 30 consecutive patients before and after MR arthrography of the shoulder was performed. Presence and width of any anechoic collection was noted within various locations (biceps tendon sheath, subscapular recess (neutral position and internal rotation), posterior glenohumeral joint recess (neutral position and external rotation)). Injected fluid (8-12 ml) into the glenohumeral joint served as gold-standard. Widths of anechoic collections were correlated (Spearman rank correlation) with injected fluid.
  
  
  RESULTS
  Glenohumeral anechoic collection was consistently seen in the posterior glenohumeral joint recess with the arm in external rotation (100%, 30/30), and in the biceps tendon sheath (97%, 29/30). Ultrasound was not sensitive at other locations (7%-17%). Mean width in anterior-posterior direction of anechoic collection in the posterior glenohumeral joint recess was 7 mm (range: 3-18 mm), 2 mm (range: 1-7 mm) in the biceps tendon sheath. Significant correlation (R = 0.390, p = 0.033) was found between width of anechoic collection and injected fluid in the posterior glenohumeral joint recess.
  
  
  CONCLUSIONS
  Glenohumeral joint effusion can be detected and quantified most reliably in the posterior glenohumeral joint recess with the arm in external rotation.
authors.affiliation: Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland. veronika.zubler@balgrist.ch
authors.forename: Veronika
authors.initials: V
authors.lastname: Zubler
authors.forename: Nadja
authors.initials: N
authors.lastname: Mamisch-Saupe
authors.forename: Christian W A
authors.initials: CW
authors.lastname: Pfirrmann
authors.forename: Bernhard
authors.initials: B
authors.lastname: Jost
authors.forename: Marco
authors.initials: M
authors.lastname: Zanetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography / Q000379:methods; D015331:Cohort Studies; D005122:Exudates and Transudates / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult