Ultrasound imaging for the rheumatologist XLIV. Ultrasound of the shoulder in healthy individuals

CER6367
2013 Vol.31, N°2
PI 0165, PF 0171
Imaging

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PMID: 23484463 [PubMed]

Received: 14/02/2013
Accepted : 14/02/2013
In Press: 13/03/2013
Published: 15/03/2013

Abstract

OBJECTIVES:
To investigate the prevalence of shoulder ultrasound (US) detectable abnormalities in asymptomatic individuals of various ages and to correlate the US findings with clinical data.
METHODS:
97 healthy subjects were enrolled in the present study. They were subgrouped according to their age, as follows: group I (20–29 years); group II (30–39 years); group III (40–49 years); group IV (50–59 years); group V (>60 years). A physical examination of both shoulders, based on a series of provocative maneuvers, was carried out. The US assessment was performed by using a Logiq9 machine equipped with a multi-frequency linear probe working at 12MHz and included the study of a number of structures for the evaluation of local abnormalities, as follows: the long head of biceps tendon (synovial effusion (SE), synovial hypertrophy (SH), power Doppler (PD) signal); the subacromion-subdeltoid and sub-scapularis bursae (SE, SH, PD signal); the rotator cuff tendons (tendinosis, calcifications, tears, impingement); the acromionclavicular (ACJ) and gleno-humeral joints (SE, SH, PD signal, osteophytes, erosions, fibrocartilage calcifications, cartilage abnormalities, tophaceous deposits). In addition, deltoid, throchite and throchine enthesopathy were searched for.
RESULTS:
194 shoulders were studied in total. A low but variable percentage of joints of healthy individuals (3.1–13.4%) showed positive provocative maneuvers. 138 shoulders (71.1%) did not show any US abnormalities. The most frequent changes were SE of ACJ (25.5%), osteophytes of ACJ (23.3%), and supraspinatus tendinosis (20.6%). The prevalence of abnormalities progressively increased with age. Sub-clinical involvement was present in most cases, being provocative maneuvers positive only in a low percentage of joints.
CONCLUSIONS:
The present study demonstrated the presence of a wide set of US-detectable changes in healthy subjects, that were more frequently present in elderly individuals. The absence of any clinical sign of local pathology cannot exclude the presence of local abnormalities.