Pod 2 - Best evidence-based clinical practices in shoulder pain – Combination of physical exam and point of care ultrasound for diagnosis and treatment

Friday, November 17, 2023

8:15 AM – 9:15 AM CT

Location: Learning Center in the Pavilion

Session Director(s)

Nimish Mittal, MD (he/him/his)

Assistant Professor, University of Toronto
Toronto Rehabilitation Institute/ University of Toronto
Etobicoke, Ontario, Canada

Disclosure(s): No financial relationships to disclose

Faculty(s)

Nitin B. Jain, MD, Other

Professor
UT Southwestern Medical Center
Dallas, Texas

No financial relationships to disclose.
JM

Jennifer McDonald, MD

Physician, University of Ottawa Lecturer
The Ottawa Hospital
Ottawa, Ontario, Canada

No financial relationships to disclose.

Lab Marketing

Description: : Shoulder pain is one of the most common complaints seen in clinical practice. Delay in a timely, accurate diagnosis of shoulder pain can lead to significant disability. The most common causes of the painful shoulder, such as rotator cuff tendinopathy/tears, shoulder impingent, bursal pathologies, bicipital and labral pathologies, and frozen shoulder, result from disorders of periarticular soft tissues. Most of these diagnoses have overlapping clinical presentations, and available clinical tests used for diagnosis of these conditions have limited specificity and are often equivocal. Hence, it is difficult to make an accurate diagnosis in patients with shoulder pain. Point of care musculoskeletal ultrasound (US) can be used as a valuable tool for the extension of the physical exam. Static and dynamic US of shoulder helps augment diagnostic accuracy in common soft tissue pathologies of shoulder pain. Further, it offers real-time guidance for specific evidence-based therapeutic shoulder interventions for enhanced recovery of shoulder pain.

This hands-on workshop will start with a short review of the biomechanics of the shoulder joint, followed by a live demonstration of clinical exam and evidence-based special tests for shoulder pain. After that, sixty minutes of live ultrasound scanning will be demonstrated at four stations (basic, intermediate, advanced, and jeopardy) to suit the needs of learners with different levels of expertise. Learners will have the opportunity to participate and perform hands-on scanning on volunteers at all the ultrasound stations.

Why is this lab needed? : Clinicians need to keep up to date with the latest evidence and newer approaches regarding diagnosis and treatment of shoulder pain. Combining the point of care ultrasound with clinical tests in patients with shoulder pain will enable the physician to make a more precise diagnosis. This will enhance the formulation of patient-specific treatment plans, including the use of ultrasound-guided therapeutic interventions for accelerated recovery.

Lab Outline/Format:: This hands-on workshop will start with a short review of the biomechanics of the shoulder joint, followed by a live demonstration of clinical exam and evidence-based special tests for shoulder pain.

After that, sixty minutes of live ultrasound scanning will be demonstrated at four stations (basic, intermediate, advanced, and jeopardy) to suit the needs of learners with different levels of expertise. Learners will have the opportunity to participate and perform hands-on scanning on volunteers at all the ultrasound stations.
Learning Objectives:
1. Describe biomechanics of shoulder joint pertinent to common conditions that cause shoulder pain.
2. Recognize sonographic anatomy of shoulder relevant to shoulder injections and role of point of care ultrasound in the diagnosis of common shoulder conditions.
3. Underline the typical abnormal ultrasonographic findings of commonly involved structures in shoulder injuries.