Bipin R Shah MD DMRD DMRE
Radiologist and Sonologist Eclat Polyclinic Vile Parle (West), Mumbai
Head, Department of Radiology KB Bhabhai Hospital, Bandra West, Mumbai
Director and Radiologist: Lifescan Imaging Center 3-Tesla MRI and CT Scan, Malad West, Mumbai
Jeshil R Shah MD
Radiologist and Sonologist Apollo Clinic Khandvali West, Mumbai
Ram Y Prabhoo MS (Ortho)
Head, Department of Orthopedics VN Desai Hospital, Mukund Hospital Mukund Nagar, JB Nagar, Andheri (East) Mumbai, India
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Step by Step Sonography of the Shoulder Joint
© 2010, Jaypee Brothers Medical Publishers (P) Ltd.
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition: 2010
9789380704432
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset
5Foreword
It is indeed a pleasure to be asked to write a foreword for Bipin Shah's excellent contribution to the literature of musculoskeletal imaging. I have always felt that musculoskeletal imaging is one of the most challenging aspects of ultrasound technology. This is mainly because of the various structures that constitute the joint and their intricate anatomical relationships with one another. Certainly, this is one of the truly ‘operator oriented’ examinations in ultrasound. It is thus really appropriate that a self-explanatory book be written on the most commonly performed sonography in the musculoskeletal system—the shoulder joint.
In my experience, I find people shunning from performing ultrasound of the shoulder joint only for the fear of not understanding the anatomy as well as the pathology, since it is vital and critical that one performs the examination of the shoulder joint truly step by step and in a complete manner. This book surely helps training and providing a constant source of reference for all who are faced with common as well as uncommon shoulder abnormalities.
Coming from Bipin, who has been a pioneer in musculoskeletal ultrasound in the country, this book 6has excellent coverage of the anatomy, the correct technology for performing ultrasound of the shoulder joint as well as apt descriptions of various pathologies. The rotator cuff pathologies have been well dealt with and I am glad that even the artifacts as well as the mimics have been included in the text.
With the rapidly increasing usage of ultrasound in the musculoskeletal system, it is imperative, especially in a country like India that one uses the technology to its fullest advantage in order to cut down expensive and sophisticated investigations such as MRI in the evaluation of shoulder joint pathologies. The experience of the authors amply justifies this statement. It is certainly to the advantages of one and all practicing musculoskeletal ultrasound of the shoulder joint.
The authors and the publishers have done a superb job in making this book ‘easily readable’ and also attractive. I firmly believe that this book should be in every library as a reference book.
Congratulations to all.
Mukund S Joshi md fams
Consultant Radiologist
Jaslok Hospital and Research Centre
Mumbai
7Preface
Sonography has now acquired a very important role among the spectrum of imaging modalities available for the evaluation of shoulder pathologies. Shoulder disorders are quite common and there is a clear need of a cheap, reliable, easily available and accurate imaging modality. Shoulder sonography nicely fits in this lacuna. Other imaging modalities such as MRI and CT scan are expensive.
The biggest problem for shoulder sonography is lack of clear knowledge about the anatomy, sonographic techniques and proper interpretation of the findings of shoulder disorders and normal variants, among the sonologists and imaging persons. Hence was borne the idea of creating a book which can step by step deal with all these aspects. Emphasis is on not going much into the excessive texts and unwanted information, which are not required for routine shoulder sonography. The aim is to equip the imaging personnel with knowledge on how to do and interpret these examinations with ease.
The book begins with clinical examination techniques, technical aspects and detailed sonographic techniques with progression to rotator cuff pathologies followed by other non-rotator cuff pathologies as well as post surgical sonography and it ends with variants and mimics. Every effort has been made to instil the current knowledge and experience. The book is heavily illustrated for easier understanding of the subject.8
The accompanying DVD contains additional material on detailed sonography techniques with multiple videos, for better understanding. Sonography being a dynamic imaging modality, static images in a book, just does not provide real time information, as can be provided by sonography videos. It also contains a few case studies, to give readers the actual feel of the real world of shoulder sonography.
The task such as this cannot be completed without help from multiple persons. First of all, we would like to thank Dr Mukund Joshi for going through this book in detail and giving his valuable foreword. We would like to acknowledge the great support and encourage provided by Dr Ankit Shah, while preparing this book. Our supporting staff namely Hema, Iqra (Archana), Roshana, Laxman, Abhang and Mahesh have worked tirelessly and whole heartedly in all the preparatory work of this book. Our special thanks to all of them. We would also like to thank our family members, who have constantly supported us in every thing and have been patience with us.
Wish you happy reading!
Bipin R Shah
Jeshil R Shah
Ram Y Prabhoo