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Ultrasound-guided interventional procedures around the shoulder

  • Musculoskeletal Radiology
  • Published:
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Abstract

The aim of this review is to illustrate the spectrum of ultrasound-guided procedures around the shoulder. The shoulder is affected by a wide range of both, traumatic and degenerative diseases. Ultrasound guidance is a low-cost and safe tool to perform minimally invasive interventional procedures around the shoulder. The clinical outcome is shown by the use of clinical scores: visual analogue scale (VAS), Constant’s score and Shoulder Pain Disability Index (SPADI). Rotator cuff calcification is a common painful condition that occurs in up to 7.5 % of otherwise healthy adults. Ultrasound-guided procedures include single-needle and double-needle approach with different needles. These techniques are described and the results are critically compared. Ultrasound-guided viscosupplementation is a new therapeutic approach for treatment of several shoulder pain disorders: osteoarthritis, rotator cuff tear and tendinosis. In adhesive capsulitis, different therapeutic ultrasound-guided techniques such as corticosteroid injection, capsular distension (sodium chlorate solution; sodium chlorate and corticosteroids; air) and viscosupplementation are evaluated. Acromion-clavear injection of steroid and lidocaine solution under ultrasound guidance is easy to perform and is indicated in conservative treatment of painful osteoarthrosis. The treatment of rotator cuff tendinosis and partial tears with ultrasound-guided injection of concentrated autologous platelets is also described.

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References

  1. Bianchi S, Martinoli C (2007) Ultrasound of the musculoskeletal system. Springer, Germany

    Google Scholar 

  2. Conroy PH, Awad IT (2011) Ultrasound-guided blocks for shoulder surgery. Curr Opin Anaesthesiol 24:638–643

    Article  PubMed  Google Scholar 

  3. Plante T, Rontes O, Bloc S et al (2011) Spread of local anesthetic during an ultrasound-guided interscalene block: does the injection site influence diffusion? Acta Anaesthesiol Scand 55:664–679

    Article  CAS  PubMed  Google Scholar 

  4. Siegenthaler A, Moriggl B, Mlekusch S et al (2012) Ultrasound-guided suprascapular nerve block, description of a novel supraclavicular approach. Reg Anesth Pain Med 37:325–328

    Article  PubMed  Google Scholar 

  5. Peng PW, Cheng P (2011) Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy, and procedures. Part III: shoulder. Reg Anesth Pain Med 36:592–605

    Article  PubMed  Google Scholar 

  6. Gokalp G, Dusak A, Yazici Z (2010) Efficacy of ultrasonography-guided shoulder MR arthrography using a posterior approach. Skeletal Radiol 39:575–579

    Article  PubMed  Google Scholar 

  7. Perdikakis E, Drakonaki E, Maris T, Karantanas A (2013) MR arthrography of the shoulder: tolerance evaluation of four different injection techniques. Skeletal Radiol 42:99–105

    Article  PubMed  Google Scholar 

  8. Sconfienza LM, Serafini G, Silvestri E (2012) Ultrasound-guided musculoskeletal procedures. The upper limb. Springer, Germany

    Book  Google Scholar 

  9. Bloom JE, Rischin A, Johnston RV, Buchbinder R (2012) Image-guided versus blind glucocorticoid injection for shoulder pain. Cochrane Database Syst Rev 8:CD009147

    PubMed  Google Scholar 

  10. Sage W, Pickup L, Smith T et al (2013) The clinical and functional outcomes of ultrasound-guided vs landmark-guided injections for adults with shoulder pathology—a systematic review and meta-analysis. Rheumatology 52:743–751

    Article  PubMed  Google Scholar 

  11. Serafini G, Sconfienza LM, Lacelli F et al (2009) Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle US-guided percutaneous treatment—nonrandomized controlled trial. Radiology 252:157–164 (Erratum in Radiology 2010 Feb)

    Article  PubMed  Google Scholar 

  12. Roach KE, Budiman-Mak E, Songsiridej N et al (1991) Development of a Shoulder Pain and Disability Index. Arthritis Care Res 4:143–149

    Article  CAS  PubMed  Google Scholar 

  13. Williams JW, Donald R, Holleman JR et al (1995) Measuring shoulder function with the Shoulder Pain and Disability Index. J Rheumatol 22:727–732

    PubMed  Google Scholar 

  14. Aina R, Cardinal E, Bureau NJ et al (2001) Calcific shoulder tendinitis: treatment with modified US-guided fine-needle technique. Radiology 221:455–461

    Article  CAS  PubMed  Google Scholar 

  15. Farin PU, Jaroma H, Soimakallio S (1995) Rotator cuff calcifications: treatment with US-guided technique. Radiology 195:841–843

    CAS  PubMed  Google Scholar 

  16. del Cura JL, Torre I, Zabala R, Legorburu A (2007) Sonographically guided percutanous needle lavage in calcific tendinitis of the shoulder: short- and long-term result. AJR Am J Roentgenol 189:W128–W134

    Article  PubMed  Google Scholar 

  17. Abate M, Pulcini D, Di Iorio A, Schiavone C (2010) Viscosupplementation with intra-articular hyaluronic acid for treatment of osteoarthritis in the elderly. Curr Pharm Des 16:631–640

    Article  CAS  PubMed  Google Scholar 

  18. Gigante A, Callegari L (2011) The role of intra-articular hyaluronan (Sinovial) in the treatment of osteoarthritis. Rheumatol Int 31:427–444 (Erratum in: Rheumatol Int. 2011;31:981)

    Article  PubMed  Google Scholar 

  19. Silverstein E, Leger R, Shea KP (2007) The use of intra-articular hylan G-F 20 in the treatment of symptomatic osteoarthritis of the shoulder: a preliminary study. Am J Sports Med 35:979–985

    Article  PubMed  Google Scholar 

  20. Tagliafico A, Serafini G, Sconfienza LM et al (2011) Ultrasound-guided viscosupplementation of subacromial space in elderly patients with cuff tear arthropathy using a high weight hyaluronic acid: prospective open-label non-randomized trial. Eur Radiol 21:182–187

    Article  PubMed  Google Scholar 

  21. Chou WY, Ko JY, Wang FS et al (2010) Effect of sodium hyaluronate treatment on rotator cuff lesions without complete tears: a randomized, double-blind, placebo-controlled study. J Should Elbow Surg 19:557–563

    Article  Google Scholar 

  22. Meloni F, Milia F, Cavazzuti M et al (2008) Clinical evaluation of sodium hyaluronate in the treatment of patients with supraspinatus tendinosis under echographic guide: experimental study of periarticular injections. Eur J Radiol 68:170–173

    Article  CAS  PubMed  Google Scholar 

  23. Zuckerman JD, Cuomo F (1993) Frozen shoulder. In: Matsen FA 3rd, Fu FH, Hawkins RJ (eds) The shoulder: a balance of mobility and stability. American Academy of Orthopedic Surgery, Rosemont, pp 99–109

    Google Scholar 

  24. Duplay ES (1872) De la périarthrite scapulo-humérale et des raideurs de l’épaule qui en son la conséquence. Arch Gen Méd 20:5131–5142

    Google Scholar 

  25. Codman EA (1934) The shoulder. Thomas Todd, Boston

    Google Scholar 

  26. Bunker TD, Anthony PP (1995) The pathology of frozen shoulder: a Dupuytren-like disease. J Bone Joint Surg Br 77:677–683

    CAS  PubMed  Google Scholar 

  27. Shah N, Lewis M (2007) Shoulder adhesive capsulitis: systematic review of randomised trials using multiple corticosteroid injections. Br J Gen Pract 57:662–667

    PubMed Central  PubMed  Google Scholar 

  28. Mengiardi B, Pfirrmann CWA, Gerber C et al (2004) Frozen shoulder: MR arthrographic findings. Radiology 233:486–492

    Article  PubMed  Google Scholar 

  29. Buchbinder R, Green S, Youd JM (2003) Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev 1:CD004016

    PubMed  Google Scholar 

  30. Juel NG, Oland G, Kvalheim S et al (2013) Adhesive capsulitis: one sonographic-guided injection of 20 mg triamcinolone into the rotator interval. Rheumatol Int 33:1547–1553

    Article  CAS  PubMed  Google Scholar 

  31. Park KD, Nam HS, Lee JK et al (2013) Treatment effects of ultrasound-guided capsular distension with hyaluronic acid in adhesive capsulitis of the shoulder. Arch Phys Med Rehabil 94:264–270

    Article  PubMed  Google Scholar 

  32. Calis M, Demir H, Ulker S et al (2006) Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis? Rheumatol Int 26:536–540

    Article  CAS  PubMed  Google Scholar 

  33. Gasparre G, Fusaro I, Galletti S et al (2012) Effectiveness of ultrasound-guided injections combined with shoulder exercises in the treatment of subacromial adhesive bursitis. Musculoskelet Surg 96(Suppl 1):S57–S61

    Article  PubMed  Google Scholar 

  34. Ahn K, Jhun HJ, Choi KM et al (2011) Ultrasound-guided interventional release of rotator interval and posteroinferior capsule for adhesive capsulitis of the shoulder using a specially designed needle. Pain Physician 14:531–537

    PubMed  Google Scholar 

  35. Vuillemin V, Guerini H, Morvan G (2012) Musculoskeletal interventional ultrasonography: the upper limb. Diagn Interv Imaging 93:665–673

    Article  CAS  PubMed  Google Scholar 

  36. Allman FL Jr (1967) Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg 49:774–784

    PubMed  Google Scholar 

  37. Sabeti-Aschraf M, Ochsner A, Schueller-Weidekamm C et al (2010) The infiltration of the AC joint performed by one specialist: ultrasound versus palpation a prospective randomized pilot study. Eur J Radiol 75:e37–e40

    Article  CAS  PubMed  Google Scholar 

  38. Chahal J, Van Thiel GS, Mall N et al (2012) The role of platelet-rich plasma in arthroscopic rotator cuff repair: a systematic review with quantitative synthesis. Arthroscopy 28:1718–1727

    Article  PubMed  Google Scholar 

  39. Mei-Dan O, Carmont MR (2011) The role of platelet-rich plasma in rotator cuff repair. Sports Med Arthrosc 19:244–250

    Article  PubMed  Google Scholar 

  40. Gosens T, Peerbooms JC, van Laar W, den Oudsten BL (2011) Epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med 39:1200–1208

    Article  PubMed  Google Scholar 

  41. Monto RR (2012) Platelet-rich plasma treatment for chronic Achilles tendinosis. Foot Ankle Int 33:379–385

    Article  PubMed  Google Scholar 

  42. Owens RF Jr, Ginnetti J, Conti SF, Latona C (2011) Clinical and magnetic resonance imaging outcomes following platelet-rich plasma injection for chronic midsubstance Achilles tendinopathy. Foot Ankle Int 32:1032–1039

    Article  PubMed  Google Scholar 

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Conflict of interest

Alberto Tagliafico, Giuseppe Russo, Sara Boccalini, Johan Michaud, Andrea Klauser, Giovanni Serafini and Carlo Martinoli declare no conflict of interest.

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Authors and Affiliations

  1. Department of Experimental Medicine, Institute of Anatomy, DIMES, University of Genova, Vie de Toni 14, 16132, Genoa, Italy

    Alberto Tagliafico

  2. Radiology Department, School of Medicine, Università di Genova, Largo Rosanna Benzi 8, 16138, Genoa, Italy

    Giuseppe Russo & Sara Boccalini

  3. Department of Physiatry, University of Montreal, Montreal, QC, Canada

    Johan Michaud

  4. Department of Diagnostic Radiology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Andrea Klauser

  5. Department of Radiology, Santa Corona Hospital, Pietra Ligure, SV, Italy

    Giovanni Serafini

  6. Radiology Department, DISSAL, Università di Genova, Largo Rosanna Benzi 8, 16138, Genoa, Italy

    Carlo Martinoli

  7. Department of Experimental Medicine, Institute of Anatomy, DIMES, University of Genova, Largo Rosanna Benzi 8, 16132, Genoa, Italy

    Alberto Tagliafico

Authors
  1. Alberto Tagliafico
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  2. Giuseppe Russo
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  3. Sara Boccalini
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  4. Johan Michaud
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  5. Andrea Klauser
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  6. Giovanni Serafini
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  7. Carlo Martinoli
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Correspondence to Alberto Tagliafico.

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Tagliafico, A., Russo, G., Boccalini, S. et al. Ultrasound-guided interventional procedures around the shoulder. Radiol med 119, 318–326 (2014). https://doi.org/10.1007/s11547-013-0351-2

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  • DOI: https://doi.org/10.1007/s11547-013-0351-2

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