Abstract
Objectives
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.
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References
Middleton WD, Edelstein G, Reinus WR, Melson GL, Murphy WA (1984) Ultrasonography of the rotator cuff: technique and normal anatomy. J Ultrasound Med 3:549–551
Middleton WD, Teefey SA, Yamaguchi K (1998) Sonography of the shoulder. Semin Musculoskelet Radiol 2:211–222
Strobel K, Zanetti M, Nagy L, Hodler J (2004) Suspected rotator cuff lesions: tissue harmonic imaging versus conventional US of the shoulder. Radiology 230:243–249
Moosikasuwan JB, Miller TT, Burke BJ (2005) Rotator cuff tears: clinical, radiographic, and US findings. Radiographics 25:1591–1607
Martinoli C, Bianchi S, Prato N et al (2003) US of the shoulder: non-rotator cuff disorders. Radiographics 23:381–401, quiz 534
Papatheodorou A, Ellinas P, Takis F, Tsanis A, Maris I, Batakis N (2006) US of the shoulder: rotator cuff and non-rotator cuff disorders. Radiographics 26:e23
Zanetti M, Hodler J (2000) Imaging of degenerative and posttraumatic disease in the shoulder joint with ultrasound. Eur J Radiol 35:119–125
Crass JR, Craig EV, Thompson RC, Feinberg SB (1984) Ultrasonography of the rotator cuff: surgical correlation. J Clin Ultrasound 12:487–491
Teefey SA, Middleton WD, Yamaguchi K (1999) Shoulder sonography. State of the art. Radiol Clin North Am 37:767–785
Seibold CJ, Mallisee TA, Erickson SJ, Boynton MD, Raasch WG, Timins ME (1999) Rotator cuff: evaluation with US and MR imaging. Radiographics 19:685–705
Bouffard JA, Lee SM, Dhanju J (2000) Ultrasonography of the shoulder. Semin Ultrasound CT MR 21:164–191
Crass JR, Craig EV, Bretzke C, Feinberg SB (1985) Ultrasonography of the rotator cuff. Radiographics 5:941–953
Lin J, Jacobson JA, Fessell DP, Weadock WJ, Hayes CW (2000) An illustrated tutorial of musculoskeletal sonography: part 2, upper extremity. AJR Am J Roentgenol 175:1071–1079
Redondo MV, Berna-Serna JD, Campos PA et al (2008) MR arthrography of the shoulder using an anterior approach: optimal injection site. AJR Am J Roentgenol 191:1397–1400
Bureau NJ, Chhem RK, Cardinal E (1999) Musculoskeletal infections: US manifestations. Radiographics 19:1585–1592
Luukkainen R, Sanila MT, Luukkainen P (2007) Poor relationship between joint swelling detected on physical examination and effusion diagnosed by ultrasonography in glenohumeral joints in patients with rheumatoid arthritis. Clin Rheumatol 26:865–867
Naredo E, Aguado P, De Miguel E et al (2002) Painful shoulder: comparison of physical examination and ultrasonographic findings. Ann Rheum Dis 61:132–136
Schmidt WA, Schicke B, Krause A (2008) Which ultrasound scan is the best to detect glenohumeral joint effusions? Ultraschall Med 29(Suppl 5):250–255
Strunk J, Lange U, Kurten B, Schmidt KL, Neeck G (2003) Doppler sonographic findings in the long bicipital tendon sheath in patients with rheumatoid arthritis as compared with patients with degenerative diseases of the shoulder. Arthritis Rheum 48:1828–1832
Arslan G, Apaydin A, Kabaalioglu A, Sindel T, Luleci E (1999) Sonographically detected subacromial/subdeltoid bursal effusion and biceps tendon sheath fluid: reliable signs of rotator cuff tear? J Clin Ultrasound 27:335–339
Neumann CH, Holt RG, Steinbach LS, Jahnke AH Jr, Petersen SA (1992) MR imaging of the shoulder: appearance of the supraspinatus tendon in asymptomatic volunteers. AJR Am J Roentgenol 158:1281–1287
Schmidt WA, Schmidt H, Schicke B, Gromnica-Ihle E (2004) Standard reference values for musculoskeletal ultrasonography. Ann Rheum Dis 63:988–994
Koski JM (1989) Axillar ultrasound of the glenohumeral joint. J Rheumatol 16:664–667
Koski JM (1991) Validity of axillary ultrasound scanning in detecting effusion of the glenohumeral joint. Scand J Rheumatol 20:49–51
Seltzer SE, Finberg HJ, Weissman BN, Kido DK, Collier BD (1979) Arthrosonography: gray-scale ultrasound evaluation of the shoulder. Radiology 132:467–468
Schmidt WA, Volker L, Zacher J, Schlafke M, Ruhnke M, Gromnica-Ihle E (2000) Colour Doppler ultrasonography to detect pannus in knee joint synovitis. Clin Exp Rheumatol 18:439–444
Bruyn GA, Pineda C, Hernandez-Diaz C et al (2010) Validity of ultrasonography and measures of adult shoulder function and reliability of ultrasonography in detecting shoulder synovitis in patients with rheumatoid arthritis using magnetic resonance imaging as a gold standard. Arthritis Care Res (Hoboken) 62:1079–1086
Moss SG, Schweitzer ME, Jacobson JA et al (1998) Hip joint fluid: detection and distribution at MR imaging and US with cadaveric correlation. Radiology 208:43–48
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Zubler, V., Mamisch-Saupe, N., Pfirrmann, C.W.A. et al. Detection and quantification of glenohumeral joint effusion: reliability of ultrasound. Eur Radiol 21, 1858–1864 (2011). https://doi.org/10.1007/s00330-011-2127-1
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DOI: https://doi.org/10.1007/s00330-011-2127-1