Several different imaging techniques are available for
evaluating the rotator cuff and biceps tendon. The most
common disorders of impingement, rotator cuff tears and
biceps tendonitis are discussed along with the role which the
various imaging modalities can play in establishing their
diagnosis. Plain radiographs can be helpful, particularly with
a history of trauma but give limited information on the soft
tissues. Ultrasound is a useful and inexpensive method of
assessing the rotator cuff and biceps tendon, but there are
some limitations and various reports on its accuracy.
Computed tomography (CT) is most helpful in evaluation of
shoulder trauma, but gives limited information on the soft
tissues. Magnetic resonance imaging (MRI) is an accurate
imaging modality for evaluating the rotator cuff and biceps
tendon, allowing visualization of the soft tissues and the
adjacent bony structures.5
Dynamic shoulder
ultrasonography is a noninvasive, accurate method used to
assess the rotator cuff tendons. It can be incorporated into the
in-office physical examination of patients at risk for rotator
cuff problems. The low cost, convenience, and lack of risk
turn dynamic ultrasonography into an excellent imaging tool
for evaluating the biceps, subscapularis, infraspinatus, teres
minor, and supraspinatus tendons. In-office ultrasound, also
provides an opportunity for patient education and
explanation of management options.8