US is underused in the United States because of the availability of MR imaging. In Europe, it is the first-line examination technique for many pathologic conditions of the soft tissues. Sonography can often provide information similar to that of MR imaging for a fraction of the cost. This is especially important in today's world of cost containment. However, sonographic examination of the rotator cuff is technically difficult to master.
Success depends greatly on the experience and expertise of the operator.
The diagnosis must be made in real time, not from hard-copy images.