Elastography of the Shoulder – A Game Changer for Diagnosis, Prognosis and Monitoring

Abstract

The supraspinatus tendon is a key component of the rotator cuff and plays a critical role in overhead function of the shoulder. Overuse tendinopathy and tears of the supraspinatus are is a common cause of shoulder pain and functional limitation. The aim of this paper is to summarise the body of work undertaken by our group evaluating supraspinatus tendon shear wave elastography (SWE) in shoulder pathology, with a focus on diagnosis, prognosis, and monitoring. In adhesive capsulitis, a condition characterised by painful restriction of both active and passive glenohumeral motion, supraspinatus tendon stiffness increased by approximately 50–100%. In supraspinatus tendinopathy, stiffness was reduced by approximately 25–35%. In rotator cuff tear cohorts, increasing age was associated with a 10–15% reduction in stiffness per decade, and larger tears demonstrated stiffness values approximately 20–40% lower than smaller tears. Following rotator cuff repair, supraspinatus tendon stiffness increased progressively by approximately 20–25% over 12 months. Increased elastographic stiffness in adhesive capsulitis explains the decreased re-tear rate in patients with rotator cuff repairs and stiffness going into surgery or coming out of surgery

Keywords: shoulder rotator cuff, frozen shoulder, elastography, ultrasound diagnosis

DOI: 10.54941/ahfe1007213