Abstract
Purpose: Can a surgeon use a Sonosite Ultrasound scanner to provide a one stop clinic, accurately detect cuff pathology and reduce delay from 8 months to same day?
Method: A surgeon, who had been involved in the development of shoulder ultrasound since 1984, personally purchased a 10MHz Sonosite scanner for his shoulder clinic.
Results: 191 scans were performed in 6 months; 111 to detect a cuff tear; 23 for impingement; 13 postoperatively; 8 for calcific tendonitis and 8 for biceps problems. 50 scans showed a normal cuff. 141 abnormal scans showed multiple abnormalities; 72 bicipital, 15 subscapular and 309 changes in supraspinatus. Of the supra-spinatus abnormalities 48 had irregular bone, 46 focal concavities, 36 focal discontinuity and 39 excess fluid in the bursa. Ultrasound was helpful in 168 patients, unhelpful in 23 of which 8 were unsatisfactory scans due to obesity, muscle or postoperative changes. Of the 168 helpful scans a change in diagnosis was made in 19, confirmatory abnormality in 99 and normality in 50.
Conclusion:
Surgeons can use ultrasound with confidence, the Sonosite scanner is accurate at detecting full thickness tears, calcifications may be over-reported. LHB can be assessed beyond the reach of arthroscopy and 191 patients have avoided an 8 month wait for a ten minute procedure. However the surgeon was placed under extreme duress by the radiology department attempting to block him from improving his service.
The abstracts were prepared by David Stanley. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.
