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Evaluation of diagnostic precision of ultrasound for rotator cuff disorders in patients with shoulder pain

Aminzadeh B, Najafi S, Moradi A, Abbasi B, Farrokh D, Emadzadeh M

The Archives of Bone and Joint Surgery 2020 Nov;8(6):689-695

primary study

BACKGROUND: Rotator cuff disorders are a leading cause of shoulder symptoms. Accurate imaging, detecting the type of the involved muscle, and severity of the injury have important effects on the choice of treatment. Accordingly, the current study was conducted to evaluate the diagnostic accuracy of ultrasound for rotator cuff disorders in patients suffering from shoulder pain and to explore the precision of ultrasound in determining the exact dimensions of a tear in comparison with magnetic resonance imaging (MRI). METHODS: This prospective research was performed on patients clinically suspected of rotator cuff tendinopathy. An ultrasound of the shoulder was initially performed for the candidates. In this study, MRI was regarded as the modality of choice for examining the images of shoulder disorders. The European Society of Musculoskeletal Radiology (ESSR) guidelines were used to design the protocols and implement imaging measures. Based on the reference standard of MRI, the specificity and sensitivity as well as positive and negative predictive values of ultrasound in detection of rotator cuff disorders were calculated. RESULTS: A total of48 patients (22 women, 23 dominant right hands) with an average age of 51.6 +/- 8.3 years were enrolled in this study. Based on MRI findings, rotator cuff disorders were detected in 43 patients (89.5%). The most commonly observed disorders were partial-thickness rotator cuff tear (n = 17, 35.4%), full-thickness rotator cuff tear (n = 16, 33.3%), and tendinopathy (n = 10, 20.8%). Among rotator cuff disorders, the highest sensitivity of ultrasound was observed in the detection of full-thickness tear (93.7%) and rotator cuff tendinopathy (90%). The highest specificity was found in the detection of full-thickness rotator cuff tear (100%) and partial-thickness rotator cuff tear (96.7%). CONCLUSION: Based on our findings, ultrasound could be considered as a high-quality diagnostic tool to rule in partial and full-thickness rotator cuff tears and rule out the rotator cuff pathologies.

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