Table 1.
Imaging diagnostic criteria
| Pathology | Imaging Diagnostic Criteria |
|---|---|
| X-Ray | |
| Acromioclavicular joint | |
| arthropathy/degenerative change | joint space narrowing, subchondral sclerosis, subchondral cystic change or marginal osteophytes. |
| osteolysis | bony resorption or increased lucency in distal clavicle. |
| Glenohumeral joint | |
| arthropathy/degenerative change | joint space narrowing, subchondral sclerosis, subchondral cystic change or marginal osteophytes. |
| other | loose bodies, joint calcifications. |
| Calcification of rotator cuff components | |
| supraspinatus | calcific deposits adjacent to the greater tuberosity on AP-external rotation x-ray view. |
| infraspinatus | calcific deposits adjacent to the greater tuberosity on AP-internal rotation x-ray view. |
| subscapularis | calcific deposits in the anterior shoulder region on axial x-ray view. |
| Ultrasounda | |
| ACJ pathology | Capsular hypertrophy, cortical irregularity or osteophytes, capsular bulge, joint space narrowing or widening. |
| Glenohumeral joint effusion | more than 2 mm between posterior glenoid labrum and posterior capsule. |
| Rotator cuff | |
| normal | normal contour, normal echogenicity. |
| calcification | focal increase in echogenicity with or without shadowing. |
| tendinosis | tendon thickening or decreased echogenicity. |
| tear | |
| intrasubstance | hypoechoic change not extending to articular or bursal surface. |
| partial thickness | SSp and ISp: hypoechoic change extending to either the articular or bursal surface. Subscapularis: partial fibre discontinuity. |
| full thickness | SSp and ISp: hypoechoic region extends from bursal to articular surface. Subscapularis: complete fibre discontinuity. |
| Subacromial bursa | |
| bursitis | hypoechoic fluid or effusion present and >1 mm thick. |
| bursal thickening | ≥2 mm measured from deep margin of deltoid to superficial margin of supraspinatus. |
| "bunching" | Fluid distension of the SAB or 'buckling' of the rotator cuff during abduction |
| MR arthrograma | |
| Acromioclavicular joint | |
| arthropathy/degenerative changes | capsular hypertrophy with or without joint space narrowing, subchondral cystic change, bone marrow oedema or osteophytes |
| osteolysis | bony resorption or bone marrow oedema in the distal clavicle |
| Rotator cuff | |
| normal | normal contour, normal signal |
| tendinosis | tendon thickening or mild increase in T2 signal |
| intrasubstance tear | linear increase in T2 signal which does not extend to the articular or bursal surface. |
| partial thickness tear | linear increase in T2 signal extending to the (bursal or articular) margins. |
| full thickness tear | fluid signal intensity or contrast extending from the bursal to the articular side lesion of the rotator cuff. Contrast seen in the SAB. |
| Subacromial bursitis | increased T2 signal within the SAB |
| Glenohumeral joint | |
| rotator interval pathology | thickening, signal change or tear involving the biceps pulley, superior glenohumeral or coracohumeral ligament, or synovitis in the rotator interval. |
| arthropathy/degenerative change | chondral loss, subchondral sclerosis, cystic changes, bone marrow oedema or osteophytes |
| labral tear | contrast extending into- or undermining the glenoid labrum, not conforming to normal variant anatomy. |