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. 2002 Feb;61(2):132–136. doi: 10.1136/ard.61.2.132

Painful shoulder: comparison of physical examination and ultrasonographic findings

E Naredo 1, P Aguado 1, E De Miguel 1, J Uson 1, L Mayordomo 1, J Gijon-Banos 1, E Martin-Mola 1
PMCID: PMC1754006  PMID: 11796399

Abstract

Background: High frequency ultrasonography is an accurate non-invasive imaging technique for evaluating patients with painful shoulder.

Objective: To compare the clinical diagnosis established by a physical examination with high frequency ultrasonographic findings in patients with painful shoulder.

Methods: Thirty one consecutive patients with a first flare of shoulder pain were prospectively included in the study. All had a physical examination performed by two blinded rheumatologists. Ultrasonographic examination was carried out within one week of the physical examination by a third rheumatologist experienced in this technique who had no knowledge of the clinical findings. Ultrasonography was considered the optimal diagnostic technique.

Results: Clinical assessment showed low accuracy in the diagnosis of periarticular shoulder lesions.

Conclusion: Ultrasonography should be used wherever possible to improve diagnosis and treatment of painful shoulder.

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Figure 1 .

Figure 1

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Ultrasonographic transverse imaging of biceps tendinitis (left) compared with normal biceps tendon (right). Note the increased hypoechoic fluid (F) within the biceps tendon sheath, surrounding the hyperechoic tendon. BG = Bicipital groove.

Figure 2 .

Figure 2

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Ultrasonographic longitudinal imaging of a deep surface supraspinatus partial thickness tear. Note the hypoechoic fluid (F) filling the fibre defect. GT = Greater tuberosity of the humerus; SST = supraspinatus tendon; DM = deltoid muscle.

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