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Technique for shoulder ultrasonography in infants with congenital brachial plexus palsy.

BACKGROUND Glenohumeral instability is a known complication of congenital brachial plexus palsy. In certain cases, muscle imbalance leads to posterior displacement of the head of the humerus on the cartilaginous glenoid, resulting in glenoid dysplasia and varying degrees of joint subluxation. Studies using ultrasonography have demonstrated that these anatomical changes occur in the early months of life and can be reversed with prompt treatment. However, the technical challenge of obtaining standard ultrasonography in a child a few weeks old is considerable. The subject is small, mobile and unable to sit unsupported. The shoulder that is being examined must be fully exposed with the upper limb free to move in order to obtain dynamic imaging. We had previously tried several methods of supporting the baby in order to facilitate the examination to no avail until it occurred to us to use a simple proprietary seating aid.