Musculoskeletal shoulder US aids clinical decisions

Tuesday, November 29 | 9:00 a.m.-9:10 a.m. | RC304-02 | Room E450A
Musculoskeletal shoulder ultrasound is a useful diagnostic imaging modality for evaluating rotator cuff injuries, according to research being presented on Tuesday morning.

Dr. Michael Friedman of Washington University in St. Louis and colleagues reviewed 935 musculoskeletal shoulder ultrasound exams performed over a 12-month period, analyzing medical records and clinic notes of each patient and noting pre- and postultrasound diagnoses and treatment plans. The group categorized management plans into six groups:

  • No plan/no further treatment
  • Physical therapy
  • Therapeutic injection
  • Surgical intervention
  • Change in diagnosis
  • Need for additional imaging

The researchers found that of 935 exams, 72.6% had a postultrasound plan that differed from preultrasound management. In 23 patients, the diagnosis was changed to nonshoulder pathology; 12 patients were referred for additional imaging. Of 485 exams with a defined management plan before the shoulder ultrasound exam was performed, the invasiveness of the plan increased in 22.3% based on the imaging results. Of these 485 exams, clinical management was altered from surgical to nonsurgical treatment in 1.9% and from nonsurgical to surgical in 16.1%.

The bottom line? Musculoskeletal shoulder ultrasound has a significant effect on both clinical decision-making and patient management for rotator cuff pathology, Friedman's group concluded.

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