Hi Ashleigh,
Yes, I am not at all a numbers person and I think that is an advantage.
A global perspective works best I think.
With adhesive cap I look at a number of things clinically and sonographically.
Clinically I test them for external rotation range compared to the other side.
Then I stand behind them and dig a finger into the medial border of the scapula and then abduct their arm as far as they can. If the scapula stays stationary until they reach between 60 and 90 degrees of abduction the humeral head has good rotation range and they don’t have adhesive cap. If the scapula starts to swing laterally early in the abduction this is due to a loss of humeral rotation capability at the GH joint and this is a good clue for adhesive cap. It is called the scapulo-humeral rhythm. You need a set of normal plain radiographs as advanced GH joint OA or a bony mass / old fracture remodelling etc can cause the lack of rotation. But if the plain x-rays are fairly normal it is a great test.
Then I like to see a bit of fluid in the long head of biceps sheath as this communicates with the GH joint and the fluid is squeezed out of the GH joint when the capsule contracts and into the LHBT sheath.
Then I look for flow in the rotator cuff interval with whatever your most sensitive Doppler tool is on your machine. The arm must be relaxed in the lap (not modified Crass) and NO transducer pressure, relaxed patient, high gain , low PRF (scale).
Then look at the posterior capsule for thickness and assess during internal and external rotation. Compare capsule thickness and range of movement with the other side.
Then I lay them down, arms up as far as they can and scan the inferior glenohumeral ligament (axillary GH joint capsule) and compare to the other side to see if it thick.
If you do all of this I reckon you get it right nearly all the time.
Happy scanning,
Steve