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Ultrasound is a reliable imaging modality for diagnosing and assessing musculoskeletal disorders. Recent advancements in ultrasound technology have substantially improved image resolution, enabling the visualization of anatomic structures on a near-microscopic level. However, existing guidelines for standardized shoulder ultrasound primarily rely on earlier machine models and settings that may not harness the full potential of these high-resolution imaging capabilities. This article provides a simple and systematic guide to high-resolution sonography of the shoulder using anatomical and histological images from cadavers for comparison. International standard techniques are considered, and images were obtained using modern equipment. This two-article series systematically shows the examination and normal findings, presenting first the posterior, then frontal, then further anterior, followed by lateral and, optionally, the axillary examination. In this article, the focus is on the posterior and coronal shoulder.

Hands-on courses utilizing preserved human tissues for educational training offer an important pathway to acquire basic anatomical knowledge. Owing to the reevaluation of formaldehyde limits by the European Commission, a joint approach was chosen by the German-speaking anatomies in Europe (Germany, Austria, Switzerland) to find commonalities among embalming protocols and infrastructure. A survey comprising 537 items was circulated to all anatomies in German-speaking Europe. Clusters were established for "ethanol"-, formaldehyde-based ("FA"), and "other" embalming procedures, depending on the chemicals considered the most relevant for each protocol. The logistical framework, volumes of chemicals, and infrastructure were found to be highly diverse between the groups and protocols. Formaldehyde quantities deployed per annum were three-fold higher in the "FA" (223 L/a) compared to the "ethanol" (71.0 L/a) group, but not for "other" (97.8 L/a), though the volumes injected per body were similar. "FA" was strongly related to table-borne air ventilation and total fixative volumes =1000 L. "Ethanol" was strongly related to total fixative volumes >1000 L, ceiling- and floor-borne air ventilation, and explosion-proof facilities. Air ventilation was found to be installed symmetrically in the mortuary and dissection facilities. Certain predictors exist for the interplay between the embalming used in a given infrastructure and technical measures. The here-established cluster analysis may serve as decision supportive tool when considering altering embalming protocols or establishing joint protocols between institutions, following a best practice approach to cater toward best-suited tissue characteristics for educational purposes, while simultaneously addressing future demands on exposure limits.

[english] Background: In view of the continuously increasing number of beginners of medical students at the Ludwig-Maximilians-University (LMU), the traditional kind of the practically oral tests on the cadaver for the assessment in tests of anatomy has become no longer reliably and practically realisable. Material and Methods: As an alternative was an exam-course established, where the students have to pass in turn different stations with preparations and to work on relating tasks. We investigated the practicability, reliability and the students' acceptance of this form of testing. Results: In 7 parallel prepaired exam-courses, 930 students can be testet within 155 minutes with time and effort of 2 academic teachers and 32 student co-workers. The results show an adequate selectivity high reliability and apropriate difficulty. Results of a written evaluation of 442 students (49%) show a high acceptance of this kind of testing. Summary: This kind of test represents an alternative, which has to be taken seriously, to the traditional form of anatomical tests. [german] Hintergrund: Angesichts der stetig steigenden Zahl (WS 06/07 n=930) an Studienanfängern der Medizin in München ist im Fach Anatomie die traditionelle Prüfungsform der praktischen, mündlichen Prüfung am Präparat für die Bewertung in den Testaten nicht mehr zuverlässig und praktikabel durchführbar. Material & Methoden: Als Alternative wurde ein Prüfungsparcours etabliert, in dem die Studierenden der Reihe nach unterschiedliche Stationen mit ausgelegten Präparaten durchlaufen und entsprechende Aufgaben bearbeiten. Wir untersuchten die Praktikabilität, Zuverlässigkeit und studentische Akzeptanz des Prüfungsformates. Ergebnisse: Durch sieben parallel aufgebaute Prüfungsparcours können 930 Studierende in 155 Minuten mit einem Betreuungsaufwand von zwei akademischen und 32 studentischen Mitarbeitern geprüft werden. Die Ergebnisse zeigen eine adäquate Trennschärfe, hohe Zuverlässigkeit und angemessene Schwierigkeit der Prüfung. Ergebnisse einer schriftlichen Evaluation von 442 Studierenden (49%) sprechen für eine hohe Akzeptanz des Prüfungsformates. Schlussfolgerung: Wir halten diese Form der Prüfung als ernst zu nehmende Alternative zur bisher in den anatomischen Testaten traditionellen Form der mündlichen Prüfung am Präparat.

Degenerative or traumatic ruptures of the distal biceps tendon are less common than proximal lesions. Distal lesions lead to a significant loss of function with usually considerable discomfort for patients. Therefore, precise diagnostics using operator-dependent high-resolution musculoskeletal ultrasound with illustration of the extent of the affected tendon lesion are important for optimizing patient management. In this article, we discuss the precise high-resolution musculoskeletal ultrasound and sonoanatomy of the distal biceps tendon and emphasize its importance for the surgical treatment of tendon lesions. In this review and pictorial essay, we first focus on the description of the precise anatomy and ultrasound anatomy of this clinically important region. Furthermore, we highlight different ultrasound scanning techniques for the correct assessment of the distal biceps tendon. Various approaches for optimal sonographic assessment of the distal biceps tendon have been suggested in the literature: the anterior approach, the lateral access, the medial access and the posterior approach. In the second part of the article, we focus on the evaluation of surgical repair techniques of distal biceps tendon lesions considering the extent of the rupture zone of the distal biceps tendon based on the ultrasound findings. Surgical techniques are explained from the orthopedic surgical point of view.