Dynamic Shoulder Ultrasound
Dynamic shoulder ultrasound is a clinical examination of the shoulder with the added bonus of being able to observe internal structures as they move, which is not possible with other imaging modalities. Movement can be active or passive and the examination needs to be tailored to each patient. Prior to any study, a short history and examination are essential. Often a diagnosis such as adhesive capsulitis can be made before you scan the patient.
One of the main prerequisites for understanding and performing a dynamic study is to understand the surgical term “impingement syndrome”, i.e. pain on abduction due to abnormal compression of the supraspinatus tendon and overlying subacromial bursa between the humeral head and coracoacromial arch. Movement of the tendon and bursa are observed, as well as any abnormal movement of for example, the scapula. In some impingement, buckling and bunching of the tendon and bursa deep to the coracoacromial ligament is seen. This is also called “subacromial crowding.” Surgeons have slightly varying definitions of impingement and would probably appreciate your subtle but strong suggestion of impingement rather than a diagnosis.
Shoulder ultrasound is performed to assess the cause of shoulder pain. Besides impingement, other less common causes of shoulder pain will be mentioned. The causes of shoulder pain and how to perform a dynamic study will be discussed.
Importantly, a dynamic study of the shoulder should be included in your standard shoulder ultrasound examination.