Unknown Tendons, Muscles and Nerves of the Shoulder: Proposal for a Standardized Ultrasound-guided Examination, a "mini GEL" Experience.

Thanks to its excellent spatial resolution and dynamic aspect, ultrasound of the shoulder allows an optimal evaluation of tendon, muscle and nerve' structures in shoulder pain. Through this article and owing to inter-observer reproducibility, we will describe an ultrasound standardized protocol (posterior, anterior, global plane) in basic first ultrasounds (ie without tendon abnormality of the supra/infra spinatus, the biceps and subscapularis).

The effects of interscalene brachial plexus block on humeral arterial blood flow: a Doppler ultrasound study.

In this study we investigated and quantified the effects of interscalene block (ISB) on humeral arterial blood flow (HBF). Eleven patients scheduled for shoulder arthroscopic surgery under ISB were prospectively studied. A Doppler ultrasound of the humeral artery was performed before, and 30 min after, the ISB. The resistance index and the HBF were measured at the level of the midpoint of the upper arm. The median (interquartile range) of resistance index decreased from 0.98 (0.95-1.00) to 0.81 (0.77-0.91) (P < 0.01). The median HBF increased from 32 (18-46) to 88 (59-98) mL/min (P < 0.01). We conclude that ISB enhances arterial blood flow and decreases arterial resistance.