Ultrasound of Subscapularis, Teres Major, and Latissimus Dorsi in ABER Position

Shoulder ultrasound is an essential tool in musculoskeletal diagnostics, widely used by healthcare practitioners to evaluate and treat various upper girdle conditions. While magnetic resonance imaging (MRI) remains the gold standard for shoulder imaging, ultrasound offers a more accessible, practical, and superior approach for dynamic assessments of musculoskeletal pathologies. Muscles like the subscapularis, teres major, and latissimus dorsi are frequently involved in conditions such as myofascial pain and spasticity, yet there is limited literature detailing their evaluation for both diagnostic and therapeutic purposes. Traditional shoulder ultrasound methods often exclude detailed imaging of the subscapularis muscle due to its deep anatomical position beneath the scapula, which interferes with sound wave penetration. However, we present a novel approach that facilitates visualization of the subscapularis, teres major, and latissimus dorsi muscles using the ABduction and External Rotation (ABER) position. This method serves as a valuable addition to the conventional shoulder sonography protocol. By positioning the patient semi-recumbent with their arms raised above and behind their head, clinicians can access these critical muscles, providing not only diagnostic insights but also potential therapeutic interventions. The ABER position allows for clear imaging of these muscles, which play a significant role in shoulder movement and are often implicated in spasticity disorders. This approach is particularly appealing to musculoskeletal practitioners as it provides an efficient and straightforward method for assessing muscle belly pathologies. Additionally, it enhances clinical capabilities in diagnosing and treating conditions affecting the subscapularis, teres major, and latissimus dorsi muscles, offering an improved workflow for both diagnostic evaluation and therapeutic interventions.