Musculoskeletal

SHOULDER PAIN – USS is only indicated if the following criteria are met:

 

TRAUMATIC

Young active patients with shoulder pain, caused by acute trauma

AND with clinical signs & symptoms suggestive of a complete rotator cuff tear

Arrange an urgent USS and next available fracture clinic review if a tear is confirmed

 

ATRAUMATIC

Patients >40yrs with atraumatic shoulder pain, which has failed to respond to conservative measures (including either physio and/or steroid injection).

Initially arrange an X ray.

IF orthopaedic surgery is the preferred next step, arrange a routine USS with results available for OPD Orthopaedic appointment. Please state on the ultrasound referral form that surgery is being considered.

 

POST-OP

Patients with a history of previous rotator cuff repair where there are concerns regarding a recurrent rupture.

Arrange an urgent USS and urgent OPD Orthopaedic review if a tear is confirmed

 

Requests for shoulder USS which do not explicitly meet these criteria will be cancelled. Where a delay is likely to adversely affect the patient we will endeavour to speak with the referrer or the practice secretary prior to cancellation.

Local physio and/or the Musculoskeletal interface (MSKi) service often provide a helpful alternative for patients who do not quite meet these criteria. The MSKi service is able to refer directly to the orthopaedic team, with an USS when they feel this is indicated. 

Further guidance can be found at the link below:
https://rms.cornwall.nhs.uk/rms/primary_care_clinical_referral_criteria/orthopaedics/shoulder_and_elbow

 

 

ACHILLES TENDINOPATHY – does not require an ultrasound. Guidance can be found at the link below:
https://rms.cornwall.nhs.uk/primary_care_clinical_referral_criteria/orthopaedics/foot_and_ankle/hindfoot/achilles_tendinopathy

 

 

The guidelines above have been developed in conjunction with the RCHT Radiology Department. Should you feel that there is a need for clinical imaging outside of the criteria stated above then you may find it helpful to obtain advice from radiology email enquiries. They aim to respond within 24hrs and the email address is 

rch-tr.GPRadiologyEnquiries@nhs.net

 

Date Reviewed                   11/03/2022

Date of Next Review           11/03/2023

Author                                 Dr Rebecca Hopkins

 

Version                  1.1