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Table 1 Imaging diagnostic criteria

From: A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks

Pathology Imaging Diagnostic Criteria
X-Ray  
Acromioclavicular joint  
   arthropathy/degenerative change joint space narrowing, subchondral sclerosis, subchondral cystic change or marginal osteophytes.
   osteolysis bony resorption or increased lucency in distal clavicle.
Glenohumeral joint  
   arthropathy/degenerative change joint space narrowing, subchondral sclerosis, subchondral cystic change or marginal osteophytes.
   other loose bodies, joint calcifications.
Calcification of rotator cuff components  
   supraspinatus calcific deposits adjacent to the greater tuberosity on AP-external rotation x-ray view.
   infraspinatus calcific deposits adjacent to the greater tuberosity on AP-internal rotation x-ray view.
   subscapularis calcific deposits in the anterior shoulder region on axial x-ray view.
Ultrasound a  
ACJ pathology Capsular hypertrophy, cortical irregularity or osteophytes, capsular bulge, joint space narrowing or widening.
Glenohumeral joint effusion more than 2 mm between posterior glenoid labrum and posterior capsule.
Rotator cuff  
   normal normal contour, normal echogenicity.
   calcification focal increase in echogenicity with or without shadowing.
   tendinosis tendon thickening or decreased echogenicity.
   tear  
   intrasubstance hypoechoic change not extending to articular or bursal surface.
   partial thickness SSp and ISp: hypoechoic change extending to either the articular or bursal surface. Subscapularis: partial fibre discontinuity.
   full thickness SSp and ISp: hypoechoic region extends from bursal to articular surface. Subscapularis: complete fibre discontinuity.
Subacromial bursa  
   bursitis hypoechoic fluid or effusion present and >1 mm thick.
   bursal thickening ≥2 mm measured from deep margin of deltoid to superficial margin of supraspinatus.
   "bunching" Fluid distension of the SAB or 'buckling' of the rotator cuff during abduction
MR arthrogram a  
Acromioclavicular joint  
   arthropathy/degenerative changes capsular hypertrophy with or without joint space narrowing, subchondral cystic change, bone marrow oedema or osteophytes
   osteolysis bony resorption or bone marrow oedema in the distal clavicle
Rotator cuff  
   normal normal contour, normal signal
   tendinosis tendon thickening or mild increase in T2 signal
   intrasubstance tear linear increase in T2 signal which does not extend to the articular or bursal surface.
   partial thickness tear linear increase in T2 signal extending to the (bursal or articular) margins.
   full thickness tear fluid signal intensity or contrast extending from the bursal to the articular side lesion of the rotator cuff. Contrast seen in the SAB.
Subacromial bursitis increased T2 signal within the SAB
Glenohumeral joint  
   rotator interval pathology thickening, signal change or tear involving the biceps pulley, superior glenohumeral or coracohumeral ligament, or synovitis in the rotator interval.
   arthropathy/degenerative change chondral loss, subchondral sclerosis, cystic changes, bone marrow oedema or osteophytes
   labral tear contrast extending into- or undermining the glenoid labrum, not conforming to normal variant anatomy.
  1. Abbreviations: AP, antero-posterior view; ACJ, acromioclavicular joint; SSp, supraspinatus; ISp, infraspinatus; SAB, subacromial bursa;
  2. adefinitions based upon accepted diagnostic criteria [33, 35]