Purpose or Case Report: Background:
Sonographic techniques are simple and safe. The utility and clinical value of dynamic sonographic evaluation of the glenohumeral joint in infants with brachial plexus injury (BPBI) has been described since the late 1990's. However, this technique remains an underutilized tool in most imaging practices. Brachial plexus injury during the birthing process can lead to glenoid dysplasia, posterior shoulder subluxation and significant morbidity if left untreated. Imaging evaluation of the degree of deformity is paramount to guide clinical treatment and the follow-up of complicated cases. Imaging techniques include MRI, CT and US. Shoulder ultrasound provides a dynamic, noninvasive method of evaluation. It has also been our experience that this imaging technique can be mastered by the Sonographer and supported with accurate interpretation by the Radiologist.

Purpose:
Describe the imaging features of glenohumeral joint dysplasia due to BPBI with emphasis on ultrasound technique.
Review step-by-step dynamic sonographic evaluation of the glenohumeral joint in BPBI with emphasis on correct positioning of the patient to ensure consistency and reproducible quality imaging.
Improve both confidence and independent evaluation of patients through this presentation by the sonographer.
Methods & Materials:
Proper technique will be demonstrated utilizing multiplanar dynamic imaging techniques performed with high frequency linear transducers. Tips for proper patient positioning in the abducted and adducted shoulder positions will be included. The normal glenohumeral joint anatomy will be shown as well as cases of varying degrees of shoulder dysplasia.
Results: Knowledge of proper patient positioning and imaging planes is crucial in order to accurately evaluate for pathology. With proper technique, ultrasound can evaluate the severity of shoulder dysplasia and help guide treatment.
Conclusions: Dynamic ultrasound can be used successfully to evaluate the infant shoulder for evaluation of BPBI. The techniques can be mastered by a sonographer and radiologist in the setting of clear concise practical techniques, resulting in broader scopes of practice.