Radiologic evaluation of the shoulder girdle

Physical Medicine and Rehabilitation, University of Utah Health Sciences Center, 30 North 1900 East, Salt Lake City, UT 84132-2119, USA.
Physical Medicine and Rehabilitation Clinics of North America (Impact Factor: 0.93). 06/2004; 15(2):373-406. DOI: 10.1016/j.pmr.2004.01.004
Source: PubMed


The radiologic evaluation of the shoulder girdle is an important adjunct to the clinical history and physical examination. Close collaboration between musculoskeletal clinicians and musculoskeletal radiologists improves the diagnostic performance of imaging studies. Technologic advantages, especially in MRI, have improved appreciation of shoulder anatomy, biomechanics, and injury patterns, allowing for the development of more targeted surgical and nonsurgical treatment strategies. This article reviews imaging considerations of the major clinical entities related to the shoulder.

17 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 56-year-old previously well left-handed woman presents to her family physician with a 2-year history of pain and stiffness in her left shoulder. She describes a constant ‘ache’ that became ‘sharp’ when playing tennis or golf. Over the last 2 months, the pain has become increasingly worse and she has had to reduce her tennis matches from four times per week to only once. On examination, there was a soft tissue swelling over the left shoulder with no bruising or muscle wasting. Her pain reproduced with active abduction of the left shoulder while the passive range of motion was full. There was reduced power with abduction and flexion of the shoulder. Sensation was intact in the upper extremity. Plain films and an ultrasound examination were performed (figures 1 and 2).
    British Journal of Sports Medicine 04/2013; 47(17). DOI:10.1136/bjsports-2013-092320 · 5.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Imaging plays a key role in the assessment of shoulder problems. Given the wide array of radiological options at the clinician's disposal, selection of proper imaging modalities at different levels or types of shoulder abnormalities may be challenging. We aim in this article to review the various imaging techniques that are available for the evaluation of shoulder problems and to highlight the key points in choosing the relevant imaging examinations. We also mention some of the radiological findings encountered in patients with shoulder problems. Cervical spinal abnormalities, which may sometimes present with shoulder problems, and their imaging assessments are beyond the scope of this review. In many cases, close collaboration with imaging experts is essential in deciding on the imaging approach to shoulder problems in a timely and cost-effective manner. Nevertheless, some imaging algorithms are available for common problems related to the shoulder region. © 2014 by Turkish Society of Physical Medicine and Rehabilitation.
    FTR - Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi 07/2014; 60(1):68-77. DOI:10.5152/tftrd.2014.36744 · 0.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Study Design Case report. Background Comprehensive treatment strategies are needed for individuals with glenohumeral joint (GHJ) osteoarthritis (OA), especially when they are young and active. Prior dislocation with or without subsequent shoulder stabilization surgery complicates the clinical presentation and increases the risk of OA progression. The purpose of this case report is to describe an orthopedic manual physical therapy approach used in a patient with GHJ OA who presented with shoulder pain and impaired movement. Case Description A 38-year-old male military officer presented with a 2 month duration of left shoulder pain, unrelieved with a subacromial injection. He reported a history of anterior-inferior dislocation with subsequent stabilization surgery 15 years prior and arthroscopic subacromial decompression 2 years prior. Physical examination demonstrated painful limitations in shoulder elevation and internal/external rotation movements, stiffness with testing using accessory glides, and rotator cuff and scapular musculature weakness associated with pain. Outcomes Treatment consisted of 5 sessions provided over 4 weeks. The plan of care included manual physical therapy, exercises, and progressive functional activities specifically tailored to the patient's clinical presentation. Shoulder pain and disability index (SPADI) scores decreased from 43% to 17% and the patient specific functional scale (PSFS) average score improved from 3.0 to 7.25. After 4 additional weeks of a home exercise program, the SPADI score was 4% and PSFS average score was 9.0. Improvements in self-reported function were maintained at 6 months. Four "booster" treatment sessions were administered at 9 months contributing to sustained outcomes through 1 year. Discussion In a young, active patient with GHJ OA, clinically meaningful short-term improvements in self-reported function and pain, maintained at 1 year, were observed with manual physical therapy and exercise. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther, Epub 30 Apr 2015. doi:10.2519/jospt.2015.5887.
    06/2015; 46(6):453-461. DOI:10.2519/jospt.2015.5887