Open Access Research article

Ultrasound-diagnosed disorders in shoulder patients in daily general practice: a retrospective observational study

Ramon PG Ottenheijm1*, Inge GM van’t Klooster1, Laurens MM Starmans1, Kurt Vanderdood2, Rob A de Bie3, Geert-Jan Dinant1 and Jochen WL Cals1

Author Affiliations

1 Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, Maastricht, MD 6200, The Netherlands

2 Department of Radiology, Orbis Medical Centre, Dr. H. van der Hoffplein 1, Sittard-Geleen, BG 6162, The Netherlands

3 Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, Maastricht, MD 6200, The Netherlands

For all author emails, please log on.

BMC Family Practice 2014, 15:115  doi:10.1186/1471-2296-15-115

Published: 10 June 2014



Ultrasound imaging (US) is considered an accurate and widely available method to diagnose subacromial disorders. Yet, the frequency of the specific US-diagnosed shoulder disorders of patients with shoulder pain referred from general practice is unknown. We set out to determine the frequency of specific US-diagnosed shoulder disorders in daily practice in these patients and to investigate if the disorders detected differ between specific subgroups based on age and duration of pain.


A predefined selection of 240 ultrasound reports of patients with shoulder pain (20 reports for each month in 2011) from a general hospital (Orbis Medical Centre Sittard-Geleen, The Netherlands) were descriptively analysed. Inclusion criteria were: (i) referral from general practice, (ii) age ≥18 years, and (iii) unilateral shoulder examination. Subgroups were created for age (<65 years and ≥65 years) and duration of pain (acute or subacute (<12 weeks) and chronic (≥12 weeks)). The occurrence of each specific disorder is expressed as absolute and relative frequencies.


With 29%, calcific tendonitis was the most frequently diagnosed disorder, followed by subacromial-subdeltoid bursitis (12%), tendinopathy (11%), partial-thickness tears (11%), full-thickness tears (8%) and AC-osteoarthritis (0.4%). For 40% of patients, no disorders were found on US. Significantly more full thickness-tears were found in the ≥65 years group. ‘No disorders’ was reported significantly more often in the <65 years group. The supraspinatus tendon was the most frequently affected tendon (72%).


Calcific tendonitis is the most common US-diagnosed disorder affecting patients in general practice, followed by subacromial-subdeltoid bursitis, tendinopathy, partial- and full-thickness tears and AC-osteoarthritis. Full-thickness tears were diagnosed significantly more frequently in patients ≥65 years, while ‘no disorders’ was more frequently reported in patients <65 years. Our findings imply that patients can be stratified into diagnostic subgroups, allowing more tailored treatment than currently applied.

Shoulder; Shoulder impingement syndrome; Rotator cuff; Ultrasound; General practice