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,

Firstly thanks for your comments about the fires. Last summer was the worst ever. I am in Adelaide / South Australia and we have a beautiful, pristine wilderness island called Kangaroo Island. It is fairly large (a bit over 100Km from end to end) and about 2/3 of it was incinerated which is absolutely tragic. We also had big local fires in the Adelaide hills so it was a bad summer. Luckily we have fared fairly well with the Covid crisis with only a small number of deaths and no community transmission at this moment.
As for your suggestion, I love it. I agree the arm above the head is difficult with the adhesive capsulitis patients but if you lay them supine and assist them I can usually get the job done and I am providing a bit of free physiotherapy!

Can you please send through a dodgy i-phone photo of your patient position and transducer position for us as well as the resulting clinical imaging. You can see the tab below the text box for uploading attachments.
I want to try it out right away,

Happy scanning,

Steve.

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