Shoulder pain is one of the most common musculoskeletal complaints in adults, affecting approximately 20–30% of the population at any given time. The shoulder is the most mobile joint in the body, which makes it inherently vulnerable to soft tissue injury.
| Condition | Typical presentation |
|---|---|
| Rotator cuff tear | Pain on lifting the arm, weakness, often worse at night; may follow a specific injury or develop gradually |
| Rotator cuff tendinopathy | Aching pain on overhead activity; no specific injury; often bilateral |
| Subacromial bursitis | Pain on the outer aspect of the shoulder; painful arc between 60–120° of abduction |
| Biceps tendon pathology | Pain in the front of the shoulder; may be associated with a "pop" or visible deformity (Popeye sign) if ruptured |
| Acromioclavicular joint (ACJ) pathology | Pain at the top of the shoulder, over the ACJ; often follows a fall on the outstretched hand |
| Frozen shoulder (adhesive capsulitis) | Gradual onset of stiffness and pain; loss of both active and passive range of movement; typically self-limiting over 18–24 months |
| Glenohumeral osteoarthritis | Deep aching pain; loss of range of movement; typically in older adults |
A shoulder ultrasound scan is appropriate when:
A shoulder ultrasound at Sonoworld provides a dynamic, real-time assessment of the soft tissue structures of the shoulder, including:
The dynamic capability of ultrasound — the ability to image the shoulder in motion — is a significant advantage over MRI for assessing impingement and rotator cuff function.
| Factor | Ultrasound | MRI |
|---|---|---|
| Rotator cuff tears | Excellent — sensitivity 87–96% for full-thickness tears | Excellent — gold standard for labral and bone pathology |
| Dynamic assessment | ✅ Yes — can assess impingement in real time | ❌ No — static images only |
| Guided injection | ✅ Yes — can guide injection in the same appointment | ❌ No |
| Cost | Lower | Higher |
| Wait time at Sonoworld | 24–48 hours | Not available at Sonoworld |
| Labral tears | Limited | Gold standard |
For most presentations of shoulder pain, ultrasound is the appropriate first-line investigation. MRI is reserved for cases where labral pathology, bone marrow oedema, or nerve compression is suspected.
The most common scenario we see is a patient who has been told by their GP that they have "shoulder impingement" and has been referred for physiotherapy. After 6–8 weeks of physiotherapy without improvement, they come to us for a scan. In a significant proportion of these cases, the ultrasound identifies a partial or full-thickness rotator cuff tear — a finding that changes the management pathway entirely. Physiotherapy alone is not the appropriate treatment for a significant rotator cuff tear; the patient needs a surgical opinion. Early imaging avoids months of ineffective treatment.
No. The scan is entirely painless. You will be asked to move your arm into various positions during the scan, which may cause some discomfort if your shoulder is already painful, but the ultrasound itself does not cause pain.
No. You can book directly at Sonoworld without a GP referral.
Ultrasound-guided injections are available at Sonoworld. The scan and injection can be performed in the same appointment. See our guide to ultrasound-guided injections for more information.
Sonoworld is registered with the Care Quality Commission (CQC). Our sonographers are registered with HCPC and are members of BMUS. All scans are performed at our Marylebone clinic: 29 Weymouth Street, London W1G 7DB.
Same-day and next-day appointments available at our Marylebone clinic. Instant verbal results. Written report within 24 hours. No GP referral required.
Price: £235
Or call us on 020 7486 1991
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