title: Dynamic high-resolution ultrasound of the shoulder: how we do it.
abstract: Ultrasonography (US) is an established and well-accepted modality that can be used to evaluate articular and peri-articular structures around the shoulder. US has been proven to be useful in a wide range of rotator cuff diseases (tendon tears, tendinosis, and bursitis) as well as non-rotator cuff abnormalities (instability problems, synovial joint diseases, and nerve entrapment syndromes). Diagnostic accuracy of shoulder US when evaluating rotator cuff tears can reach 91-100% for partial and full thickness tears detection, respectively, having been reported to be as accurate as magnetic resonance imaging in experienced hands. US is cheap, readily available, capable to provide high-resolution images, and does not use ionizing radiations. In addition, US is the only imaging modality that allows performing dynamic evaluation of musculoskeletal structures, that may help to further increase diagnostic performance. In this setting, a standardized imaging protocol is essential for an exhaustive and efficient examination, also helping reducing the intrinsic dependence from operators of US. Furthermore, knowledge of pitfalls that can be encountered when examining the shoulder may help to avoid erroneous images interpretation. In this article we use detailed anatomic schemes and high-resolution US images to describe the normal US anatomy of soft tissues, articular, and para-articular structures located in and around the shoulder. Short video clips emphasizing the crucial role of dynamic maneuvers and dynamic real-time US examination of these structures are included as supplementary material.
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova, Italy. Electronic address: angelcoraz@libero.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Corazza
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova, Italy. Electronic address: theabo@libero.it.
authors.forename: Davide
authors.initials: D
authors.lastname: Orlandi
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova, Italy. Electronic address: emanuele.fabbro@gmail.com.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Fabbro
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova, Italy. Electronic address: giulio.ferrero@gmail.com.
authors.forename: Giulio
authors.initials: G
authors.lastname: Ferrero
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Piazza Malan 2, 20097 San Donato Milanese, Italy. Electronic address: carmelomessina.md@gmail.com.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Messina
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova, Italy. Electronic address: riccardo.sartoris@hotmail.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Sartoris
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova, Italy. Electronic address: silvy-86-@hotmail.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Perugin Bernardi
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via Alberti 4, 16132 Genova, Italy. Electronic address: a.arcidiacono84@gmail.com.
authors.forename: Alice
authors.initials: A
authors.lastname: Arcidiacono
authors.affiliation: Dipartimento di Radiologia, Ospedale Evangelico Internazionale, Corso Solferino 29A, 16121 Genova, Italy. Electronic address: silvi.enzo@gmail.com.
authors.forename: Enzo
authors.initials: E
authors.lastname: Silvestri
authors.affiliation: Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 1, 20097 San Donato Milanese, Milano, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2, 20097 San Donato Milanese, Italy. Electronic address: io@lucasconfienza.it.
authors.forename: Luca Maria
authors.initials: LM
authors.lastname: Sconfienza
mesh_terms: D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging* / Q000473:pathology; D017006:Rotator Cuff / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000473:pathology; D012782:Shoulder / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000473:pathology; D012785:Shoulder Joint / Q000033:anatomy & histology / Q000473:pathology / Q000648:ultrastructure*; D014463:Ultrasonography
keywords: Acromion-clavicular joint; Dynamic maneuvers; Rotator cuff; Shoulder; Ultrasonography