Skip to main content
Top
Published in: Skeletal Radiology 12/2016

01-12-2016 | Scientific Article

How is shoulder ultrasound done in Italy? A survey of clinical practice

Authors: Marcello Zappia, Alberto Aliprandi, Simona Pozza, Fabio Martino Doniselli, Salvatore Gitto, Luca Maria Sconfienza

Published in: Skeletal Radiology | Issue 12/2016

Login to get access

Abstract

Objectives

To define when an ultrasound examination of the shoulder can be considered complete and how many examinations currently performed in Italy are actually complete according to that definition.

Materials and methods

Reports and images of previously performed ultrasound examinations of the shoulder of patients seen in 2014 for interventional procedures were reviewed for the following items, according to guidelines published by the European Society of Musculoskeletal Radiology: long biceps, subscapularis, supraspinatus, external rotators, acromioclavicular joint, subacromial bursa, subacromial space, coraco-acromial ligament, and the posterior recess. The first six items were considered mandatory in a complete shoulder ultrasound examination. The specialization of the performing physician was noted. The number of complete examinations performed by different physicians was compared with the number of incomplete examinations.

Results

We analyzed 324 examinations (212 women, 112 men; mean age = 47 ± 12 years). The most frequently reported item was the supraspinatus tendon (83 %), the least frequently reported was the posterior recess (3 %). The image that was most frequently found was the long head of the biceps tendon (77 %), the least frequently found was the coraco-acromial ligament (3 %). The median number of images/examination was 6 (25th–75th percentiles, range 4–9). The mean number of unrecognizable images was 3 (2–4). A radiologist performed the examination in 269 patients (83 %). The rate of complete examinations was 47 %. The number of complete examinations performed by physicians from different specialties was not significantly different from that of incomplete examinations (P = 0.228).

Conclusions

Complete shoulder ultrasound examinations account for less than 50 % of those performed in clinical practice in some Italian regions. Standardized scanning protocols and structured reporting may help to improve this figure and consistency among providers performing these examinations.
Literature
1.
go back to reference Corazza A, Orlandi D, Fabbro E, et al. Dynamic high-resolution ultrasound of the shoulder: how we do it. Eur J Radiol. 2015;84(2):266–77.CrossRefPubMed Corazza A, Orlandi D, Fabbro E, et al. Dynamic high-resolution ultrasound of the shoulder: how we do it. Eur J Radiol. 2015;84(2):266–77.CrossRefPubMed
2.
go back to reference Jacobson JA. Shoulder US: anatomy, technique, and scanning pitfalls. Radiology. 2011;260(1):6–16.CrossRefPubMed Jacobson JA. Shoulder US: anatomy, technique, and scanning pitfalls. Radiology. 2011;260(1):6–16.CrossRefPubMed
3.
go back to reference Klauser AS, Tagliafico A, Allen GM, et al. Clinical indications for musculoskeletal ultrasound: a Delphi-based consensus paper of the European Society of Musculoskeletal Radiology. Eur Radiol. 2012;22(5):1140–8.CrossRefPubMed Klauser AS, Tagliafico A, Allen GM, et al. Clinical indications for musculoskeletal ultrasound: a Delphi-based consensus paper of the European Society of Musculoskeletal Radiology. Eur Radiol. 2012;22(5):1140–8.CrossRefPubMed
4.
go back to reference Martinoli C, Bianchi S, Prato N, et al. US of the shoulder: non-rotator cuff disorders. Radiographics. 2003;23(2):381–401; quiz 534.CrossRefPubMed Martinoli C, Bianchi S, Prato N, et al. US of the shoulder: non-rotator cuff disorders. Radiographics. 2003;23(2):381–401; quiz 534.CrossRefPubMed
5.
go back to reference Nazarian LN, Jacobson JA, Benson CB, et al. Imaging algorithms for evaluating suspected rotator cuff disease: Society of Radiologists in Ultrasound consensus conference statement. Radiology. 2013;267(2):589–95.CrossRefPubMedPubMedCentral Nazarian LN, Jacobson JA, Benson CB, et al. Imaging algorithms for evaluating suspected rotator cuff disease: Society of Radiologists in Ultrasound consensus conference statement. Radiology. 2013;267(2):589–95.CrossRefPubMedPubMedCentral
6.
go back to reference Teefey SA, Hasan SA, Middleton WD, Patel M, Wright RW, Yamaguchi K. Ultrasonography of the rotator cuff. A comparison of ultrasonographic and arthroscopic findings in one hundred consecutive cases. J Bone Joint Surg Am. 2000;82(4):498–504.PubMed Teefey SA, Hasan SA, Middleton WD, Patel M, Wright RW, Yamaguchi K. Ultrasonography of the rotator cuff. A comparison of ultrasonographic and arthroscopic findings in one hundred consecutive cases. J Bone Joint Surg Am. 2000;82(4):498–504.PubMed
7.
go back to reference Vlychou M, Dailiana Z, Fotiadou A, Papanagiotou M, Fezoulidis IV, Malizos K. Symptomatic partial rotator cuff tears: diagnostic performance of ultrasound and magnetic resonance imaging with surgical correlation. Acta Radiol. 2009;50(1):101–5.CrossRefPubMed Vlychou M, Dailiana Z, Fotiadou A, Papanagiotou M, Fezoulidis IV, Malizos K. Symptomatic partial rotator cuff tears: diagnostic performance of ultrasound and magnetic resonance imaging with surgical correlation. Acta Radiol. 2009;50(1):101–5.CrossRefPubMed
8.
go back to reference de Jesus JO, Parker L, Frangos AJ, Nazarian LN. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR Am J Roentgenol. 2009;192(6):1701–7.CrossRefPubMed de Jesus JO, Parker L, Frangos AJ, Nazarian LN. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. AJR Am J Roentgenol. 2009;192(6):1701–7.CrossRefPubMed
10.
go back to reference Le Corroller T, Cohen M, Aswad R, Pauly V, Champsaur P. Sonography of the painful shoulder: role of the operator’s experience. Skeletal Radiol. 2008;37(11):979–86.CrossRefPubMed Le Corroller T, Cohen M, Aswad R, Pauly V, Champsaur P. Sonography of the painful shoulder: role of the operator’s experience. Skeletal Radiol. 2008;37(11):979–86.CrossRefPubMed
11.
go back to reference O’Connor PJ, Rankine J, Gibbon WW, Richardson A, Winter F, Miller JH. Interobserver variation in sonography of the painful shoulder. J Clin Ultrasound. 2005;33(2):53–6.CrossRefPubMed O’Connor PJ, Rankine J, Gibbon WW, Richardson A, Winter F, Miller JH. Interobserver variation in sonography of the painful shoulder. J Clin Ultrasound. 2005;33(2):53–6.CrossRefPubMed
12.
go back to reference Arend CF. Top ten pitfalls to avoid when performing musculoskeletal sonography: what you should know before entering the examination room. Eur J Radiol. 2013;82(11):1933–9.CrossRefPubMed Arend CF. Top ten pitfalls to avoid when performing musculoskeletal sonography: what you should know before entering the examination room. Eur J Radiol. 2013;82(11):1933–9.CrossRefPubMed
13.
go back to reference Rutten MJ, Jager GJ, Blickman JG. From the RSNA refresher courses: US of the rotator cuff: pitfalls, limitations, and artifacts. Radiographics. 2006;26(2):589–604.CrossRefPubMed Rutten MJ, Jager GJ, Blickman JG. From the RSNA refresher courses: US of the rotator cuff: pitfalls, limitations, and artifacts. Radiographics. 2006;26(2):589–604.CrossRefPubMed
14.
go back to reference Rutten MJ, Maresch BJ, Jager GJ, Blickman JG, van Holsbeeck MT. Ultrasound of the rotator cuff with MRI and anatomic correlation. Eur J Radiol. 2007;62(3):427–36.CrossRefPubMed Rutten MJ, Maresch BJ, Jager GJ, Blickman JG, van Holsbeeck MT. Ultrasound of the rotator cuff with MRI and anatomic correlation. Eur J Radiol. 2007;62(3):427–36.CrossRefPubMed
15.
go back to reference American College of Radiology, Society for Pediatric Radiology, Society of Radiologists in Ultrasound. AIUM practice guideline for the performance of a musculoskeletal ultrasound examination. J Ultrasound Med. 2012;31(9):1473–88. American College of Radiology, Society for Pediatric Radiology, Society of Radiologists in Ultrasound. AIUM practice guideline for the performance of a musculoskeletal ultrasound examination. J Ultrasound Med. 2012;31(9):1473–88.
17.
go back to reference Van Holsbeeck M, Introcaso J. Sonography of the shoulder. In: Van Holsbeeck M, Introcaso J, ed. Musculoskeletal ultrasound. St Louis: Mosby; 2001. p. 463–516 Van Holsbeeck M, Introcaso J. Sonography of the shoulder. In: Van Holsbeeck M, Introcaso J, ed. Musculoskeletal ultrasound. St Louis: Mosby; 2001. p. 463–516
19.
go back to reference Messina C, Banfi G, Orlandi D, et al. Ultrasound-guided interventional procedures around the shoulder. Br J Radiol. 2016;89(1057):20150372.CrossRefPubMed Messina C, Banfi G, Orlandi D, et al. Ultrasound-guided interventional procedures around the shoulder. Br J Radiol. 2016;89(1057):20150372.CrossRefPubMed
20.
go back to reference Lanza E, Banfi G, Serafini G, et al. Ultrasound-guided percutaneous irrigation in rotator cuff calcific tendinopathy: what is the evidence? A systematic review with proposals for future reporting. Eur Radiol. 2015;25(7):2176–83.CrossRefPubMed Lanza E, Banfi G, Serafini G, et al. Ultrasound-guided percutaneous irrigation in rotator cuff calcific tendinopathy: what is the evidence? A systematic review with proposals for future reporting. Eur Radiol. 2015;25(7):2176–83.CrossRefPubMed
21.
go back to reference Sconfienza LM, Randelli F, Sdao S, Sardanelli F, Randelli P. Septic bursitis after ultrasound-guided percutaneous treatment of rotator cuff calcific tendinopathy. PM R. 2014;6(8):746–8.CrossRefPubMed Sconfienza LM, Randelli F, Sdao S, Sardanelli F, Randelli P. Septic bursitis after ultrasound-guided percutaneous treatment of rotator cuff calcific tendinopathy. PM R. 2014;6(8):746–8.CrossRefPubMed
22.
go back to reference Sconfienza LM, Vigano S, Martini C, et al. Double-needle ultrasound-guided percutaneous treatment of rotator cuff calcific tendinitis: tips & tricks. Skeletal Radiol. 2013;42(1):19–24.CrossRefPubMed Sconfienza LM, Vigano S, Martini C, et al. Double-needle ultrasound-guided percutaneous treatment of rotator cuff calcific tendinitis: tips & tricks. Skeletal Radiol. 2013;42(1):19–24.CrossRefPubMed
23.
go back to reference Sconfienza LM, Bandirali M, Serafini G, et al. Rotator cuff calcific tendinitis: does warm saline solution improve the short-term outcome of double-needle US-guided treatment? Radiology. 2012;262(2):560–6.CrossRefPubMed Sconfienza LM, Bandirali M, Serafini G, et al. Rotator cuff calcific tendinitis: does warm saline solution improve the short-term outcome of double-needle US-guided treatment? Radiology. 2012;262(2):560–6.CrossRefPubMed
24.
go back to reference Tagliafico A, Serafini G, Sconfienza LM, et al. Ultrasound-guided viscosupplementation of subacromial space in elderly patients with cuff tear arthropathy using a high weight hyaluronic acid: prospective open-label non-randomized trial. Eur Radiol. 2011;21(1):182–7.CrossRefPubMed Tagliafico A, Serafini G, Sconfienza LM, et al. Ultrasound-guided viscosupplementation of subacromial space in elderly patients with cuff tear arthropathy using a high weight hyaluronic acid: prospective open-label non-randomized trial. Eur Radiol. 2011;21(1):182–7.CrossRefPubMed
25.
go back to reference Sconfienza LM, Serafini G, Sardanelli F. Treatment of calcific tendinitis of the rotator cuff by ultrasound-guided single-needle lavage technique. AJR Am J Roentgenol. 2011;197(2):W366. author reply 367.CrossRefPubMed Sconfienza LM, Serafini G, Sardanelli F. Treatment of calcific tendinitis of the rotator cuff by ultrasound-guided single-needle lavage technique. AJR Am J Roentgenol. 2011;197(2):W366. author reply 367.CrossRefPubMed
26.
go back to reference Serafini G, Sconfienza LM, Lacelli F, Silvestri E, Aliprandi A, Sardanelli F. Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle us-guided percutaneous treatment--nonrandomized controlled trial. Radiology. 2009;252(1):157–64.CrossRefPubMed Serafini G, Sconfienza LM, Lacelli F, Silvestri E, Aliprandi A, Sardanelli F. Rotator cuff calcific tendonitis: short-term and 10-year outcomes after two-needle us-guided percutaneous treatment--nonrandomized controlled trial. Radiology. 2009;252(1):157–64.CrossRefPubMed
29.
go back to reference Dunnick NR, Langlotz CP. The radiology report of the future: a summary of the 2007 Intersociety Conference. J Am Coll Radiol. 2008;5(5):626–9.CrossRefPubMed Dunnick NR, Langlotz CP. The radiology report of the future: a summary of the 2007 Intersociety Conference. J Am Coll Radiol. 2008;5(5):626–9.CrossRefPubMed
30.
go back to reference Kahn Jr CE, Heilbrun ME, Applegate KE. From guidelines to practice: how reporting templates promote the use of radiology practice guidelines. J Am Coll Radiol. 2013;10(4):268–73.CrossRefPubMedPubMedCentral Kahn Jr CE, Heilbrun ME, Applegate KE. From guidelines to practice: how reporting templates promote the use of radiology practice guidelines. J Am Coll Radiol. 2013;10(4):268–73.CrossRefPubMedPubMedCentral
32.
go back to reference Kahn Jr CE, Langlotz CP, Burnside ES, et al. Toward best practices in radiology reporting. Radiology. 2009;252(3):852–6.CrossRefPubMed Kahn Jr CE, Langlotz CP, Burnside ES, et al. Toward best practices in radiology reporting. Radiology. 2009;252(3):852–6.CrossRefPubMed
33.
go back to reference Morgan TA, Helibrun ME, Kahn Jr CE. Reporting initiative of the Radiological Society of North America: progress and new directions. Radiology. 2014;273(3):642–5.CrossRefPubMed Morgan TA, Helibrun ME, Kahn Jr CE. Reporting initiative of the Radiological Society of North America: progress and new directions. Radiology. 2014;273(3):642–5.CrossRefPubMed
36.
go back to reference Ok JH, Kim YS, Kim JM, Yoo TW. Learning curve of office-based ultrasonography for rotator cuff tendons tears. Knee Surg Sports Traumatol Arthrosc. 2013;21(7):1593–7.CrossRefPubMed Ok JH, Kim YS, Kim JM, Yoo TW. Learning curve of office-based ultrasonography for rotator cuff tendons tears. Knee Surg Sports Traumatol Arthrosc. 2013;21(7):1593–7.CrossRefPubMed
37.
go back to reference Murphy RJ, Daines MT, Carr AJ, Rees JL. An independent learning method for orthopaedic surgeons performing shoulder ultrasound to identify full-thickness tears of the rotator cuff. J Bone Joint Surg Am. 2013;95(3):266–72.CrossRefPubMed Murphy RJ, Daines MT, Carr AJ, Rees JL. An independent learning method for orthopaedic surgeons performing shoulder ultrasound to identify full-thickness tears of the rotator cuff. J Bone Joint Surg Am. 2013;95(3):266–72.CrossRefPubMed
38.
go back to reference Jamadar DA, Jacobson JA, Caoili EM, et al. Musculoskeletal sonography technique: focused versus comprehensive evaluation. AJR Am J Roentgenol. 2008;190(1):5–9.CrossRefPubMed Jamadar DA, Jacobson JA, Caoili EM, et al. Musculoskeletal sonography technique: focused versus comprehensive evaluation. AJR Am J Roentgenol. 2008;190(1):5–9.CrossRefPubMed
39.
go back to reference Filippou G, Adinolfi A, Delle Sedie A, et al. Radiologists and rheumatologists on performing and reporting shoulder ultrasound: from disagreement to consensus. Reumatismo. 2014;66(3):233–9.CrossRefPubMed Filippou G, Adinolfi A, Delle Sedie A, et al. Radiologists and rheumatologists on performing and reporting shoulder ultrasound: from disagreement to consensus. Reumatismo. 2014;66(3):233–9.CrossRefPubMed
40.
go back to reference Delzell PB, Boyle A, Schneider E. Dedicated training program for shoulder sonography: the results of a quality program reverberate with everyone. J Ultrasound Med. 2015;34(6):1037–42.CrossRefPubMed Delzell PB, Boyle A, Schneider E. Dedicated training program for shoulder sonography: the results of a quality program reverberate with everyone. J Ultrasound Med. 2015;34(6):1037–42.CrossRefPubMed
41.
go back to reference Colebatch AN, Edwards CJ, Ostergaard M, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804–14.CrossRefPubMed Colebatch AN, Edwards CJ, Ostergaard M, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804–14.CrossRefPubMed
42.
go back to reference Mandl P, Navarro-Compan V, Terslev L, et al. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis. 2015;74(7):1327–39.CrossRefPubMed Mandl P, Navarro-Compan V, Terslev L, et al. EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis. 2015;74(7):1327–39.CrossRefPubMed
Metadata
Title
How is shoulder ultrasound done in Italy? A survey of clinical practice
Authors
Marcello Zappia
Alberto Aliprandi
Simona Pozza
Fabio Martino Doniselli
Salvatore Gitto
Luca Maria Sconfienza
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 12/2016
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-016-2477-5

Other articles of this Issue 12/2016

Skeletal Radiology 12/2016 Go to the issue