Sonography as a preferred diagnostic tool to assess shoulder displacement in brachial plexus palsy

Sonographic imaging of the shoulder in an infant is a challenge for pediatric physicians, radiologists, and sonographers. At the Texas Scottish Rite Hospital for Children, sonographic techniques have been used to examine the posterior aspect of the glenohumeral joint in patients with brachial plexus palsy. Between 1999 and 2006 146 patients were evaluated by sonography, including 124 patients who were assessed both before and after therapeutic intervention. The sonographic findings were accurate and reliable in providing diagnostic information. The advantages are that ultrasonic energy involves no ionizing radiation and is noninvasive, examination times are shorter than computed tomography (CT) or magnetic resonance imaging (MRI), costs are lower, and no sedation is needed in preparation. Results showed that when properly performed, sonography is a diagnostic tool preferable over plain x-ray, CT, MRI, and arthrography in evaluating the shoulder in infants.