Semiquantitative Evaluation of Extrasynovial Soft Tissue Inflammation in the Shoulders of Patients with Polymyalgia Rheumatica and Elderly-Onset Rheumatoid Arthritis by Power Doppler Ultrasound

Figure 1

Scanning method for the evaluation of hyperemia adjacent to the anterior aspect of the subscapularis tendon. (a) Arm and probe position for the evaluation of the subscapularis tendon in the long axis. The shoulder is in a neutral position, the elbow is fixed to 90°, and the hand is spinated. The probe is placed perpendicular to the shoulder. (b) Long axis ultrasound view of the subscapularis tendon (arrow). The subscapularis tendon is superficial to the lesser tuberosity and medial to the bicipital groove. Note that the hypoechoic appearance of the medial part of the subscapularis tendon is due to the anisotropy. The area indicated by an ellipse, including the anterior soft tissues and the posterior tendon tissues and excluding the bicipital groove, is assessed for the severity of hyperemia.

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