Clinical evaluation versus ultrasonographic findings in the diagnosis of painful shoulder

ABSTRACT

The differentiation of causes of shoulder pain is a clinical challenge. Among a wide variety of conditions that may produce similar shoulder pain and dysfunction, periarticular disorders play the main role. Accurate diagnosis is therapeutically important and early management may prevent capsulitis and rotator cuff lesions from becoming adhesive, so true frozen shoulder may be avoided. With the advent of high-resolution ultrasonography, interest in musculoskeletal sonography has increased and it can be used to evaluate the accuracy of clinical diagnosis of painful shoulder. Our aim was to compare the clinical diagnosis established by a physical examination with high frequency ultrasonographic findings in patients with painful shoulder. Twenty-seven consecutive patients were prospectively included in the study. All had a physical examination performed. Utrasonographic examination was carried out within one week of the physical examination. Ultrasonography was considered the optimal diagnostic technique. Our results showed that the clinical assessment had low accuracy in the diagnosis of periarticular shoulder lesions. Ultrasonography should be used whenever possible to improve diagnosis and treatment of painful shoulder