Comparative Study between MRI and Ultrasound Sensitivity in Supporting Clinically Diagnosed Rotator Cuff Tear
AbstractABSTRACT Background: The rotator cuff tendons are the key to the healthy function of the shoulder. Rotator cuff problems are frequently seen by orthopedic surgeons and tear of the rotator cuff usually considered a painful injury and event. Diagnosis is usually made through detailed history, physical examination and often imaging studies.Â Objectives: To compare the sensivity of ultrasonography and magnetic resonance imaging for detection of rotator cuff tears (partial or full thickness) in patients with shoulder pain clinically diagnosed as rotator cuff tears. Methods: During period from March 2013 to January 2015, 48 patients diagnosed as rotator cuff tear either partial or complete tear according to clinical examination 20 patients with full thickness tear and 28 patients with partial thickness tear all patients were send for US and MRI study to confirm the diagnosis at Al-Yarmouk Teaching hospital where we compare the results.
Results: Age ranging from (18 to 62) years with a mean of (48.6) years, 30 males (62.5%) and 18 females (37.5%). Dominant side was affected in (33) patients (68.75%), the non-dominant side was affected in (15) patients (31.25%). Among the 20 patients diagnosed as full thickness tear 17 patients (85%) were having full thickness tear and two patients (10%) were having partial thickness tear and one patient (5%) was having intact tendon.
Among the 28 patients diagnosed as partial thickness tear 18 patients (64.3%) were having partial thickness tear and four patients (14.3%) were having full thickness tear and six patients (21.4%) were having negative result (intact tendon). Sensitivity of US in detection of full thickness tear was 85% and sensitivity of US in detection of partial thickness tear was 64.3%. Among the 20 patients diagnosed as full thickness tear 13 patients (65%) were having full thickness tear and five patients (25%) were having partial thickness tear and two patients (10%) were having intact tendon. Among the 28 patients diagnosed as partial thickness tear 25 patients (89.3%) were having partial thickness tear and two patients (7.1%) were having full thickness tear and one patient (3.6%) was having negative result (intact tendon). Sensitivity of MRI in detection of full thickness tear was 65% while the sensitivity of MRI in detection of partial thickness tear was 89.3%.
Conclusions: Full thickness tear is diagnosed mainly by clinical examinations and ultrasonography is useful in the diagnosis with sensitivity of (85%). MRI is not so useful in the diagnosis with sensitivity of 65%. Partial thickness tear is diagnosed mainly by clinical examination and ultrasonography is not so useful in the diagnosis with sensitivity of (64.3) and thus those patients need for further evaluation with other test like MRI with sensitivity of 89
Keywords: Rotator cuff muscle tendon tear, Ultrasound, MRI.Iraqi Medical Journal Vol. 63, No. 1, January 2017; p.65-72.
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