I’ve noticed now on a few occasions that I’m picking up colour flow in the subscap, supraspinatus and bursa when I assess for ad cap at the rotator interval. The arm is always in a relaxed state with the tendons in a non stress position
The tendon fibres sometimes only shown very minor tendinopathic changes on B-mode so I was wondering if this could be use to diagnose a very mild tendinosus??? Part of the reason I ask is that MRI are being reported as mild tendinosus whilst the ultrasounds are be reported as normal.
Also would seeing flow within the bursal walls help in assessing for an adhesive bursitis???
I agree entirely with you. The reason we don’t see flow in the cuff tendons is that we examine them under some tension. When you do correct cuff interval vascularity assessment you have the cuff relaxed and transducer pressure very light and you may see flow in the subscap and SST if there is some tendinosis. I think this is a real finding and may be helpful to suggest a degree of tendinosis.
You may see flow in the bursa with bursitis but I am not sure this makes me think of an adhesive bursa, rather just a synovium proliferative bursa. The only way I can predict adhesive bursitis is by looking for a complex echogenic structure to the bursa in B-mode and far better, how they respond during injection.