الفهرس 
INTRODUCTION
Anatomy of the shoulderOnly 14 pages are availabe for public view
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Abstract
Different causes of the painful shoulder are encountered; shoulder impingement comes on the top with multiple factors causing it. Causes of shoulder impingement are divided into two major groups: structural factors (related to the acromion shape and layout, ACJ, coracoid process, bursa, and humerus) and functional factors. It is crucial to determine the source, the extent, and the specific characteristics of the problem in the RCT in order to be able to recommend the right treatment (conservative or surgical). History taking and clinical examination are the cornerstones of the diagnosis of RCT abnormalities. MRI is usually used for the diagnosis of the supraspinatus muscle and tendon disorders. The initial results of US in the detection of supraspinatus muscle or tendon pathology have varied, probably due to the use of low-frequency transducers and the limited experience in the examination procedure, but gradually the technique has gained its place amongst the other techniques. This work was designed to evaluate the effectiveness of US in the assessment of supraspinatus muscle and tendon lesions as an early diagnostic method. from 1st of July 2019 to 30th of June 2020, a total of 30 patients presented with a clinical diagnosis of shoulder impingement and diagnosed by MRI as a supraspinatus lesion were enrolled in the study. The mean age of the patients was 46.17±12.86 years with a range from 21 to 62 years. The majority (60%) of patients were females. The most common complaint in the study group was chronic shoulder pain (53.3 %). Most of the patients had their complaint in the right shoulder (53.3%).Based on MRI findings; 11 (36.7%) patients had SST tendinopathy. Partial and full thickness tear of the SST present in 10 (33.3% and 9 (30%) patients, respectively. Fatty infiltration of the SSM was detected in 14 (46.7%) patients whereas volume atrophy was seen in 8 (26.7%) patients. Other lesions included infraspinatus, subscapularis tendinopathy and biceps tendinitis were determined in 2 (6.7%), 6 (20%) and 6 (20%) cases. With exception of SST partial thickness intra-substance tear and biceps tendinitis that were higher among patients younger than 45 years and SST partial thickness articular surface tear which was equal in the two age groups, all other supraspinatus lesions were higher among those patients who older than 45 years. US assessment of those patients revealed that US has comparable accuracy to MRI in the diagnosis of different lesions of supraspinatus muscle and tendon. It has 100% accuracy for the diagnosis of glenohumeral joint effusion, ACJ osteoarthritis, infraspinatus tendinopathy, and biceps tendinitis. It also, has 96.7% and 93.3% accuracy for diagnosis of SST partial and full thickness tears, respectively. For detection of subacromial impingement, Subacromial bursitis, and subscapularis tendinopathy; US has 93.3% accuracy. The least diagnostic accuracy of US is noticed with SSM fatty infiltration (73.3%), SST retraction (76%), and SSM volume atrophy (80%).Based on the current study, we recommend to; 1) perform such studies in larger samples of patients, 2) perform multicenter studies about the role of US in that issue, and 3) conduct comparable studies between findings of US and operative findings. In conclusion; US and MRI are comparable in both sensitivity and specificity. Since US is less expensive and more available, it could be considered as the screening method when supraspinatus muscle or tendon pathology is suspected, and when well- trained radiologists and high resolution equipment are available.