Musculoskeletal Ultrasound - Shoulder & Knee

Learning Objectives

- Basic anatomy in full US shoulder exam
  - Anterior (long head biceps tendon, sub-scapularis tendon), Superior (AC joint), Anterolateral (supraspinatous tendon), Posterior (Teres minor, glenohumeral joint)
- Musculoskeletal US Terminology/Signs
  - long axis view vs. short axis, dynamic maneuvers (internal vs. external rotation), tendinosis (tendon thickening and hypoechogenecity), anisotropy, Geyser sign, joint effusion, corticcal irregularity
- Common Diagnoses
  - full-thickeness rotator cuff tear, partial-thickness tear, tendinosis, and secondarily bursal effusion, biceps tendon subluxation/dislocation

Key Points

- Full-thickness tear:
- Partial thickness : can appear as a lung consolidation (lung hepatization, with dynamic air bronchograms) or as a B-line pattern (fluid, pus, or inflammation in the lung field in place of air),
- Pleural Effusion: best seen at PLAPS point to evaluate fluid accumulation
- Asthma/COPD Exacerbation, and Pulmonary Embolism will often have unremarkable lung ultrasound findings

Shoulder US Pocket Card

Introduction to Shoulder Ultrasound:

usion, biceps tendon subluxation/dislocation

Basic anatomy of the shoulder:

Glenohumeral joint (left)

Bones that make up the shoulder joint and acromioclavicular joint (AC) joint. Also redo

Basic anatomy of the shoulder:

The shoulder joint (glenohumeral joint) is made up of the head of the humerus which sits within the glenoid fossa. The fossa is surrounded by the glenoid labrum which is a fibrocartilaginous rim that stabilized the head of the humerus. Labrum is then surrounded by fibrous joint capsule known as a bursa that is lined with synovial membrane and synovial fluid. The joint is further stabilized by the surrounding muscles and tendon which provide the range of motion of a shoulder. Humeral head has two attachment proturberances, the greater and leser tubercules, divided by the intertubercular groove where the long head of biceps tendon runs (LHBT). The greater tubercle also serves as attachment for points for three of the rotator cuff muscles.

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