Rotator Cuff Injuries: Is Ultrasound Enough? A Correlation with MRI
Introduction: Shoulder pain is one of the most common presentations in Orthopaedic patients. Rotator cuff pathologies consist of a significant proportion of shoulder pathologies. With progress in imaging techniques, the preoperative detection and characterisation of rotator cuff injuries has bec...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2017-07-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
| Subjects: | |
| Online Access: | http://www.ijars.net/article_fulltext.asp?issn=0973-709x&year=2017&month=July&volume=6&issue=3&page=RO01-RO07&id=2279 |
| Summary: | Introduction: Shoulder pain is one of the most common
presentations in Orthopaedic patients. Rotator cuff
pathologies consist of a significant proportion of shoulder
pathologies. With progress in imaging techniques, the preoperative detection and characterisation of rotator cuff injuries
has become much easier. Ultrasound (USG) and Magnetic
Resonance Imaging (MRI) are the most commonly used
imaging modalities for rotator cuff tears. Excellent soft tissue
resolution, multiplanar imaging and non-invasive technique
have made MRI the imaging modality of choice in evaluation
of rotator cuff. However, high cost and limited availability
prevent it from becoming the screening modality of choice.
USG on the other hand is cheap and easily available and
hence can be made the first modality for rotator cuff tears.
Aim: To determine the efficacy of USG in detecting rotator
cuff tears in comparison to MRI.
Materials and Methods: We evaluated 50 patients of all
age groups in Department of Radiology, Gauhati Medical
College and Hospital, Assam, India, with suspicious rotator
cuff tears first by high resolution USG and then by 1.5 T MRI.
Both USG and MRI were performed by the same radiologist.
Since MRI was always followed by USG, the radiologist was
blind to the MRI results.
Results: Supraspinatus was the most commonly affected
tendon (79%). Partial thickness tears were the most
common rotator cuff pathology. USG showed a sensitivity
of 66.67%, specificity of 92.5%, PPV of 68.96% and NPV of
91.74% in detecting partial thickness tears. Whereas, USG
showed excellent results in detecting full thickness tears
with a sensitivity of 100%, specificity of 99.31%, PPV of
91.74% and NPV of 100%.
Conclusion: USG done has a near similar accuracy for
detecting full thickness rotator cuff tears as MRI and has
an acceptable accuracy for detecting partial thickness
tears too. Hence, due to its availability, accuracy and cost
effectiveness, USG should be made the first line modality
for detecting rotator cuff tears and MRI should be reserved
for indeterminate or complex cases where USG does not
suffice in serving the clinical purpose. |
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| ISSN: | 2277-8543 2455-6874 |