A shoulder ultrasound is a non-invasive medical imaging technique that utilizes high-frequency sound waves to create detailed images of the soft tissues within and around the shoulder joint. This procedure is generally painless and does not involve exposure to radiation. It provides real-time visualization, allowing healthcare professionals to observe structures in motion.
Why a Shoulder Ultrasound?
Healthcare providers often recommend a shoulder ultrasound for persistent discomfort, swelling, or reduced range of motion. This imaging helps investigate symptoms like pain after trauma or gradual stiffness. Its dynamic nature makes it particularly useful for assessing shoulder function during movement. It often serves as an initial diagnostic step, potentially avoiding more complex imaging.
Anatomy in View: What the Ultrasound Visualizes
A shoulder ultrasound effectively visualizes various soft tissue structures susceptible to injury or inflammation. These include the four rotator cuff tendons—supraspinatus, infraspinatus, subscapularis, and teres minor—which appear as uniform, fibrillar structures. The long head of the biceps tendon, located in a groove on the upper arm bone, is also clearly seen. The scan also provides views of the subacromial-subdeltoid bursa, a fluid-filled sac cushioning the tendons, and can reveal fluid collections within or around the joint. Ligaments, muscles, and the superficial surfaces of bones are also visible.
Diagnosing Shoulder Conditions
A shoulder ultrasound can identify various conditions affecting the joint’s soft tissues. It effectively detects rotator cuff tears, distinguishing between partial-thickness tears and full-thickness tears, which show complete discontinuity. The imaging can also reveal tendinopathy, which is chronic tendon damage seen as thickening or calcific deposits within the tendon. Bursitis, an inflammation of the bursae, appears as a fluid-filled and distended bursa, sometimes with thickened walls.
The ultrasound can also assess for impingement syndrome, showing abnormal compression of tendons or bursa during arm movement. Fluid accumulation, known as effusion, can be detected within the glenohumeral joint or tendon sheaths, indicating inflammation or injury. Issues with the long head of the biceps tendon, such as tendinopathy, tears, or displacement, are also identifiable. Less commonly, ultrasound can indicate nerve entrapment, often associated with cysts.
What to Expect During the Procedure
Undergoing a shoulder ultrasound is a straightforward process with minimal preparation. Patients do not need to fast or follow special instructions. The procedure lasts 15 to 30 minutes, and you will be seated, allowing the sonographer easy access to your shoulder. A clear, water-based gel will be applied to the skin, facilitating the movement of a small, handheld device called a transducer.
The sonographer moves the transducer across the skin, capturing images of the shoulder’s internal structures on a monitor. You may be asked to move your arm into different positions during the scan, as this helps visualize how tissues interact during motion. After the scan, a radiologist reviews the images, and the findings are communicated to your referring doctor, who will discuss the results and next steps with you. While ultrasound is a valuable tool, it has limitations in viewing deep bone structures or very complex joint issues, sometimes necessitating other imaging methods.