Ultrasonographic approach to visualize the medial shoulder compartment and diagnose medial glenohumeral ligament and subscapularis lesions in dogs

Ian Porter College of Veterinary Medicine, Cornell University, Ithaca, NY

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 DVM, DACVR
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Allison Miller College of Veterinary Medicine, Cornell University, Ithaca, NY

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Carol Jennings College of Veterinary Medicine, Cornell University, Ithaca, NY

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Christopher Frye College of Veterinary Medicine, Cornell University, Ithaca, NY

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 DVM, DACVSMR
DOI:
https://doi.org/10.2460/javma.24.08.0557
Volume/Issue:
Volume 263: Issue 3
Received:
29 Aug 2024
|
Accepted:
08 Oct 2024
|
Online Publication Date:
30 Oct 2024
Open access
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Abstract

OBJECTIVE

To provide a video tutorial on the diagnostic ultrasound approach to the medial compartment of the canine shoulder and provide comparisons of normal and pathological images with corresponding MRI.

ANIMALS

Dogs undergoing diagnostic ultrasound of the medial shoulder.

METHODS

The medial shoulder was positioned in flexion with external rotation to allow transducer access, clipped, and scrubbed with dilute chlorhexidine. A 2- to 14-MHz linear array probe with a footprint of 50 mm (V8 ultrasound system; Samsung) was used to visualize the medial glenohumeral ligament (MGL), subscapularis, and coracobrachialis with coupling gel, confirmed by cadaveric ultrasound-guided dye injection and dissection. Ultrasound and corresponding MRI were then used to contrast normal anatomy to a live sedated dog with clinical subscapularis tendinopathy and MGL desmopathy. Proton density–weighted MRI sequences (1.5T Vantage Orian; Canon) using a flex coil were able to identify all 3 structures and corresponded to ultrasound findings for normal and pathological anatomy.

RESULTS

Diagnostic ultrasound identified normal and abnormal structures of the medial shoulder (coracobrachialis, subscapularis, and MGL). All imaging correlated well to MRI.

CLINICAL RELEVANCE

Medial compartment disease of the shoulder is a well-described cause of canine lameness, but diagnosis has traditionally relied on MRI or arthroscopy. Prior ultrasound approaches did not distinguish MGL components, failed to consistently identify normal or surgically transected ligaments, and have not been studied in vivo. Our approach is different and can play an important role in diagnosing medial compartment lesions, as it possesses greater anatomical visualization than arthroscopy and is noninvasive, accomplished with sedation, and relatively accessible and affordable.

Abstract

OBJECTIVE

To provide a video tutorial on the diagnostic ultrasound approach to the medial compartment of the canine shoulder and provide comparisons of normal and pathological images with corresponding MRI.

ANIMALS

Dogs undergoing diagnostic ultrasound of the medial shoulder.

METHODS

The medial shoulder was positioned in flexion with external rotation to allow transducer access, clipped, and scrubbed with dilute chlorhexidine. A 2- to 14-MHz linear array probe with a footprint of 50 mm (V8 ultrasound system; Samsung) was used to visualize the medial glenohumeral ligament (MGL), subscapularis, and coracobrachialis with coupling gel, confirmed by cadaveric ultrasound-guided dye injection and dissection. Ultrasound and corresponding MRI were then used to contrast normal anatomy to a live sedated dog with clinical subscapularis tendinopathy and MGL desmopathy. Proton density–weighted MRI sequences (1.5T Vantage Orian; Canon) using a flex coil were able to identify all 3 structures and corresponded to ultrasound findings for normal and pathological anatomy.

RESULTS

Diagnostic ultrasound identified normal and abnormal structures of the medial shoulder (coracobrachialis, subscapularis, and MGL). All imaging correlated well to MRI.

CLINICAL RELEVANCE

Medial compartment disease of the shoulder is a well-described cause of canine lameness, but diagnosis has traditionally relied on MRI or arthroscopy. Prior ultrasound approaches did not distinguish MGL components, failed to consistently identify normal or surgically transected ligaments, and have not been studied in vivo. Our approach is different and can play an important role in diagnosing medial compartment lesions, as it possesses greater anatomical visualization than arthroscopy and is noninvasive, accomplished with sedation, and relatively accessible and affordable.

Keywords: ultrasound; glenohumeral ligament; subscapularis; shoulder; dog

Acknowledgments

None reported.

Disclosures

The authors have nothing to disclose. No AI-assisted technologies were used in the generation of this abstract or video.

Funding

The authors have nothing to disclose.

References

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    Gemignani F, Harel M, Livet V, et al. Pilot study of the ultrasonographic examination of the intact and transected medial glenohumeral ligament in dogs. Vet Radiol Ultrasound. 2023;64(2):306-313. doi:10.1111/vru.13164

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    Holman SN, Schaefer SL. Quantification of the field of view for standard lateral arthroscopy of the canine shoulder. Vet Comp Orthop Traumatol. 2024;37(1):37-42. doi:10.1055/s-0043-1773766

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Cover Journal of the American Veterinary Medical Association
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Publication Date:
01 Mar 2025
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