The Clinical Utility of Ultrasound Histogram Analysis in Tissue Characterization of Structures in and Around the Shoulder Joint

The aim of the present study is to explore the usefulness of histogram values in ultrasound tis sue characterization of structure in and around shoulder joint. Since the physical examination was unable to differentiate rotator cuff tendinosis from tear, impingement from partial or full thickness tear, shoulder ultrasound was performed with histogram values. 149 patients with shoulder pain were screened by ultrasound and histogram analysis. The study was done at Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India. Only the patients with shoulder pain and clinically suspected shoulder pathology were included in the study. Patients with obvious fracture or dislocation of shoulder were excluded. Clinical signs were demonstrated in 92 men (59%), 57 women (41%) in the age group of 11-68 years with the mean age of 35.74 + 11.18 years. The duration of shoulder pain was less than 24 months.The following histogram values were obtained: total area 3500-3700; adjacent retracted tendon 1100- 1250; adjacent muscle, 600-900; subdeltoid haematoma, 900-1100; glenohumeral joint, 300-350; calcified tendonitis, 61-140; subdeltoid bursal fluid, 20-30 and bicipital groove fluid 10-20. Calcific tendonitis histogram graph is biphasic. All other areas the graph is monophasic. Histogram values and the histogram graph were significant.Quantitative ultrasound histogram analysis in tissue characterization of structures in and around the shoulder joint are of great help in guiding the clinician towards patient management, partial tear of rotator cuff muscles and tendons and to characterize fluid in bursa around shoulder joint.