Dorsal projection glenohumeral capsule

[Nicklas Rudman]

Hey Stephen and fellow sonographers! First of all sending my thoughts to all you Australians having to suffer thru the hardships displayed on the news. Hoping you all stay safe from the fires.

I was hoping to get some input in the matter of measuring the glenohumeral joint capsule when suspecting capsulitis. Viewed with keen interest your video post on the topic and by chance discovered a possible alternative projection for assessing the capsule. So im talking about the one which was compared to the anterior projection of the hip joint when assessing the thickness and effusion thereof. In the video an axillar approach is described though somewhat hard to perform when range of motion is limited. Now – could it not be performed from the dorsomedial aspect of the shoulder, especially if the patient has some ability to rotate internally. I´ve tried this a few times and I think it works quite well to obtain clear images of that neck-head junction and capsule longitudinally.

Anyone else working with this projection? Comments?

Kind regards,
Nicklas

[Stephen Bird]

Hi Nicklas,

I will have a try at this, sounds good.
Can you post a photo of the patient position and the transducer position as well as the corresponding ultrasound image for us to look at?

Steve

[Nicklas Rudman]

So now I have had time to review the technique a bit more thoroughly and I think it has some value. It´s not nearly as clear as the axillar approach. I´d say it gives a fair approximation and it tends to show if the capsule is thickened – having matched it with the axillar approach to see if there is any alignement and coherency between the two projections. If there is a real clinical value I can´t really say. Regarding pictures of transducer position and corresponding US image, I have them stored locally on my smartphone and I can´t seem to log in to this site from it (or my iPad).
Have you tried this approach yet Steve? And if so, any thoughts? Find it useful?

[Stephen Bird]

Hi Nicklas,

I agree, in the end it is another access point to the capsule to compliment the others we already use and should show similar findings.
If you email the images to meat : stayintouch@birdultrasound.com.au I can load them onto the discussion for you.
I would be keen to see an example of the image and transducer position.

Steve

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