Shoulder effusion: start in the posterior recess

Question 1Which view shows a glenohumeral effusion most reliably?

1. aThe anterior view over the coracoid
2. bThe posterior recess, with the arm externally rotated
3. cThe axilla
4. dThe subacromial bursa

Question 2What does a glenohumeral effusion look like in the posterior view?

1. aA step between the humeral head and the glenoid
2. bShadowing behind the humeral head
3. cA dark space lifting the capsule off the humeral head
4. dA bright line over the glenoid

Question 3How do you confirm a small effusion is real?

1. aCompare with the other shoulder using the same settings
2. bMeasure the humeral head
3. cUse colour Doppler on the recess
4. dPress firmly with the probe

Question 4A febrile patient has a painful shoulder and a small posterior recess effusion. What do you do?

1. aArrange aspiration and orthopaedic review for possible septic arthritis
2. bDiagnose frozen shoulder
3. cReassure, as a small effusion excludes infection
4. dTreat as rotator cuff tendinopathy