Shoulder
When trying to diagnose a partial rotator cuff tear on ultrasound, how should the patient be positioned? Why should you avoid anisotropic artifact during a shoulder scan? What kind of transducer should be used for an obese patient when performing a lateral shoulder injection?
All of these questions, and more, are addressed in the shoulder course. Learn to differentiate normal and abnormal shoulder onscreen anatomy and become familiar with the transducer positioning and angling methods that will help you develop a more accurate ultrasound-guided shoulder injection technique.
Shoulder: Pretest
Assess your current knowledge in this subject area with a pretest
Shoulder: Lesson 1
Normal anatomy and technique
Shoulder: Mid-Test
Assess your knowledge of the material presented in lesson 1 with a mid-test
Shoulder: Lesson 2
Pathology
Shoulder: Post-Test
Assess your knowledge of the material presented in lesson 1 and lesson 2 with a post-test. Score 80% or higher to receive a certificate of completion.
- Subscapularis Muscle
- Coracoid Process
- Acromion Process
- Greater Tuberosity
- Transverse Humeral Ligament
- Biceps Groove
- Lesser Tuberosity
- Biceps Brachii Tendon Long Head
- Biceps Groove
- Biceps Tendon
- Biceps Sheath
- Ascending Branch of the Anterior Circumflex Humeral Artery
- Transverse Humeral Ligament
- Subacromial Bursa
- Anterior Deltoid Muscle
- Subscapularis Tendon
- Lesser Tuberosity
- Humeral Head
- Coracobrachialis and Biceps Tendon Short Head
- Subcutaneous Fat/Adipose Tissue
- Biceps Groove
- Biceps Tendon
- Ascending Branch of the Lateral Circumflex Humeral Artery
- Anterior Deltoid Muscle
- Bicep Tendon (asterisk) (BT)
- Anterior Deltoid Muscle
- Humeral Head
- Humeral Neck
- Subacromial Bursa
- Transverse Humeral Ligament (cross section)
- Biceps Tendon Sheath
- Anterior Circumflex Humeral Artery
- Bicep Tendon (BT)
- Anterior Deltoid Muscle
- Humeral Head
- Humeral Neck
- Humeral Head
- Articular Hyaline Cartilage
- Supraspinatus Tendon (before insertion)
- Infraspinatus Tendon (before insertion)
- Biceps Tendon (within the interarticular rotator cuff interval)
- Subscapularis Tendon
- Biceps Tendon
- Coracoid Process
- Subscapularis Tendon
- Humeral Head
- Lesser Tuberosity
- Lesser Tuberosity
- Subscapularis Tendon
- Coracobrachialis
- Short Head of the Biceps Tendon
- Subacromial Subdeltoid Bursa
- Lesser Tuberosity
- Subscapularis Tendon
- Coracobrachialis
- Short Head of the Biceps Tendon
- Subacromial Subdeltoid Bursa
Shoulder Anterior Subscapularis Tendon
- Coracoid
- Subscapularis
- Humeral Head
- Lesser Tuberosity
- Subscapularis
- Lesser Tuberosity
- Subacromial Bursa
- Infraspinatus (the arrow is referencing the tendon that is underneath the bursa)
- Supraspinatus
- Supraspinatus
- Infraspinatus
- Supraspinatus/Infraspinatus Interdigitation
- Posterior Corner of the Acromion Process
- Greater Tuberosity
- Infraspinatus
- Supraspinatus
- Biceps Tendon (BT)
- Subscapularis
- Superior Glenohumeral Ligament (SGHL)
- Coracohumeral Ligament (CHL)
- Supraspinatus
- Humeral Head
- Foot Print
- Greater Tuberosity (GT)
- Anchor
- Anchor
- Humeral Head
- Suture
- Greater Tuberosity (GT)
- Anterior Facet of the Greater Tuberosity (GT)
- Middle Facet of the Greater Tuberosity (GT)
- Supraspinatus Tendon (ST)
- Infraspinatus Tendon (IT)
- Biceps Tendon (BT)
- Subscapularis Tendon
- Anterior Facet (Supraspinatus Insertion)
- Middle Facet (Interdigitated Supraspinatus-Infraspinatus Insertion)—this combined insertion stretches from the anterior part of the greater tuberosity, where most of the fibers are from the supraspinatus, to the posterior part of the middle facet where most of the fibers are from the infraspinatus. In the center of this attachment complex fibers from supraspinatus and from infraspinatus interdigitate, and the tendons cannot be distinguished.
- Inferior/Posterior Facet (Teres Minor Insertion)
- Biceps Groove
- Humeral Head
- Inferior (Underneath) Surface of the Acromion
- Surface of Humeral Head
- Greater Tuberosity (where it begins a footprint)
- The Most Distal Greater Tuberosity (facet profiles)
Anterior over biceps tendon at the level of the humeral head
- Biceps tendon (longitudinal) as it emerges from its origin in the glenohumeral joint to enter the rotator cuff interval
Anterior Greater Tuberosity
- Greater Tuberosity
- Humeral Head
- Supraspinatus Tendon
- Greater Tuberosity Middle Facet
- Footprint of Infraspinatus/Supraspinatus
- Compressed-patient moves ipsilateral palm to cover the contralateral anterior humeral head
- Neutral-arm hanging at side
- Clavicle
- Acromion
- Acromioclavicular (AC) Joint Long
- Touching the other Shoulder
- Deltoid Muscle
- Supraspinatus Tendon
- Greater Tuberosity
- Articular Hyaline Cartilage
Asterisk: Bursa
- Lateral Deltoid Muscle
- Supraspinatus Tendon
- Humeral Head
- Piribursal Fat
- Subacromial/Subdeltoid Bursa
- Subscapularis Tendon
- Coracohumeral Ligament (CHL)
- Superior Glenohumeral Ligament (SGHL)
This image shows calcific tendonitis of the supraspinatus.
- Scapular Spine
- Acromion Process
- Scapular Body
- Middle Facet of the Greater Tuberosity
- Inferior Facet of the Greater Tuberosity
- Spinoglenoid Notch/Groove (containing suprascapular nerve, artery and veins)
- Posterior Glenoid Labrum
- Posterior Glenoid Tubercle of the Scapula
- Scapular Inferior Margin
- Infraspinatus Tendon
- Teres Minor Tendon
- Clavicle
- Acromion Process
- Humeral Head
- Infraspinatus Tendon
- Posterior Glenoid
- Bony Cortex of the Scapula
- Intramuscular Septum of the Muscle Belly
3. Intramuscular Septum (central aponeurosis) of the Infraspinatus
4. Spine of the Scapula
- Posterior Acromion Process
- Posterior Deltoid
- Infraspinatus Muscle
- Infraspinatus Tendon/Central Aponeurosi
- Infraspinatus Muscle
- Sagittal Humeral Head
Note: In this image, the patient’s shoulder is internally rotated.
- Posterior Deltoid Muscle
- Infraspinatus Tendon
- Spinoglenoid Notch/Groove
- Posterior Glenoid
- Joint Capsule
- Posterior Labrum
- Humeral Head
- Deltoid Fascia Septation
- Posterior Deltoid
- Middle Deltoid
- Infraspinatus Tendon
- Humeral Head
- Middle Facet of the Greater Tuberosity
Posterior Glenohumeral Joint Injection with MBe Technology OFF
- Glenoid
- Humeral Head
- Glenoid
- Humeral Head
- Glenoid Cortex
- Humeral Head
- Effusion
- Adipose Tissue
- Posterior Deltoid Muscle
- Infraspinatus Muscle
- Effusion
- Glenoid Tubercle
- Humeral Head
- Inferior Glenoid Tubercle (where the attachment of the triceps tendon short head is taking place)
- Triceps Tendon Long Head
- Bony Ridge on Posterior Scapula that Separates Teres Minor from Infraspinatus
- Infraspinatus: Transverse
- Teres Minor: Transverse
- Inferior Glenoid Tubercle of the Scapula
- Posterior Deltoid
- Triceps Tendon Long Head
- Inferior Glenoid Tubercle (origin of the triceps tendon long head)
- Triceps Long Head
- Teres Minor Muscle
- Enthesis: Teres Minor Insertion
- Infraspinatus Tendon Transverse
- Inferior Facet of the Greater Tuberosity
- Teres Minor Tendon
- Infraspinatus Tendon Transverse
- Inferior Facet of the Greater Tuberosity
- Posterior Deltoid
- Posterior Acromion
Blue Arrow: Thickened Subacromial Bursa
- Bursa Anteriorly Distended
- Biceps Tendon (BT)
- Anterior SX Neck
- Tendon Insertion: not tendinosis
This is a normal tendon showing the expected anisotropic insertion.
- Coracobrachialis and biceps short head origin is a conjoint tendon