Bone metastasis to the scapula
Shoulder pain not responding to physio - minimal change on ultrasound. No radiograph performed prior to MRI.
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Typical mass lesion in the spine of the scapula - no radiographs performed at time of the ultrasound.
Ulrasound is of very limited value in older patients with shoulder pain. X-rays should always be performed in addition and careful examination of all bony structures undertaken not just the glenohumeral joint and immediate surrounds.