[Differential diagnosis of pathological and pseudo-pathological shoulder. Clinico-ultrasonographic findings]. / Diagnosi differenziale tra spalla paralitica e pseudoparalitica. Nostra esperienza nell'integrazione clinico-ecografica.

Clinical examination for rotator cuff tears is rarely conclusive and very difficult is the differential diagnosis with lesions of the axillary nerve. In a little hospital we chose to use first non invasive and cheaper tools for this diagnosis. 24 patients were first evaluated by a physiatric MD, and radiological and ultrasound studies were then performed. Ultrasonography (US) was done with a high frequency probe (7.5 MHz). More than 85% of our patients had, in this way a quick, cheap and non invasive diagnosis, and moreover a quick rehabilitation treatment. Only 3 patients were later studied invasively by arthrography or electromyography with needle, their treatment started later. In 3 patients US demonstrates a normal rotator cuff, and so a diagnosis of nervous lesion. Four patients had a complete large tear of the rotator cuff. In 14 patients US shows small or partial tear. Our non invasive diagnosis was quick, cheap and therapy started earlier with better final results.

[Usefulness of ultrasonographic monitoring in muscle trauma for rehabilitation therapy]. / Utilità del monitoraggio ecografico nei traumi muscolari per il trattamento riabilitativo.

The authors studied the usefulness of Ultrasound imaging in the follow-up of post-traumatic muscle lesions, to allow correct rehabilitation therapy. Ultrasound (U.) made using high frequency probe (7.5 MHz) can distinguish the exact type of post-traumatic soft-tissue lesions both in contusion and stretching trauma. U. can differentiate both minor lesions such as contusions and strains and major lesions as partial and complete tears and ruptures. Minor lesions can be easily demonstrated by comparison with contralateral muscle structure. In case of major lesions U. can give an easy demonstration of possible associated lesions like hematomas and can also study their age and guide needle aspiration. More useful for a correct rehabilitation therapy approach is the U. follow-up study, so the therapy can be exactly tailored to patient's peculiar needs, and not on a possibly hazardous standardized therapy. U. imaging study follow-up has allowed us to achieve the best results in the cheapest way. The authors studied 252 patients which had major muscle lesions. U. follow-up studies allowed to value the evolution of those lesions and to decide the exact tailoring of rehabilitation therapy.