The shoulder is a very complex joint consisting of four structural regions that all contribute to shoulder joint pathology.
1. Bone,
2. Soft tissue - rotator cuff . Biceps tendon,
Subscapularis tendon,
Supraspinatus tendon,
Infraspinatus tendon and Teres major.

3. Capsule
4. Labrum.

This presentation is designed to demonstrate the complexity of this joint and how ultrasound is used to provide information for either surgery or management. High frequency ultrasound is used to demonstrate the soft tissue of the shoulder - namely the rotator cuff. This type of examination is very operator dependant and a thorough knowledge of how this joint works is imperative. Each of the above mentioned regions of the shoulder can be visualised by ultrasound and clinical examination. The clinical examination of the shoulder will be demonstrated to assist you in your diagnosis of the shoulder complaint. All these clinical appraisals will be explored and statistics will be discussed on how to diagnose a shoulder problem. If the supraspinatus tendon is compromised, you as the sonographer/sonologist must demonstrate and describe whether the tendon is partially torn, if so what side of the tendon in torn, bursal or articular, is the tendon frayed? To what percentage. The supraspinatus muscle belly is a very important structure to evaluate particularly if surgery is the only option. When is surgery the only option? Ultrasound imaging of before and after surgery will be demonstrated. Appraisal of sutures, anchors, tendon footprints and vascularity will also be discussed during this presentation.