The patient had a pain in her right shoulder for some weeks. The onset was gradual. The left shoulder was unaffected.
Analyzing the images according to the SonoSkills pathology checklist the following items are being scored:
1. Shape: the tendon sheath has swollen; the sheath has a convex appearance. The bursa SASD has increased in thickness. The long head of the biceps tendon appears to be normal.
2. Echogenicity: an anechoic zone can be seen surrounding the biceps: a biceps halo. This appears to be an effusion. The bursa SASD contains a hyperechoic substance, possibly some synovial proliferation. The biceps tendon appears to be normal.
3. Continuity: all fibers of tissues which are visualized seem to be intact.
4. Doppler: a positive power Doppler signal in the tendon sheath can be seen.
5. Function: no functional problems where seen during ultrasound guided examination.
1. Tenosynovitis and effusion of the long head of the biceps tendon sheath. The tendon sheath also shows signs of neovascularization.
2. Subacromial/subdeltoid bursitis.
Marc is founder of, and trainer at, SonoSkills. SonoSkills is an organization dedicated to MSK ultrasound education. He's also an MSK Sonographer at the Laurentius Hospital in Roermond, the Netherlands.
More Cases from Marc Schmitz
