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Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of rotator cuff tears – A comparative observational study
ESSKA Academy. Gerakopoulos E. Nov 8, 2019; 286374
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Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of rotator cuff tears – A comparative observational study

ESA Free Oral Presentations

Topic: Imaging

Seyed-Safi P., Gerakopoulos E., Thayaparan P., Sinha J.
Kings College Hospital, Trauma and Orthopaedics, London, United Kingdom

Introduction: Rotator cuff tear is a clinical condition very frequently encountered by Orthopaedic Shoulder surgeons and the accurate diagnosis is very important for its appropriate management. Clinical examination of a shoulder is often of limited value and imaging modalities such as Ultrasonography (US) and Magnetic Resonance Imaging (MRI) play an important role in decision making regarding the management of rotator cuff pathologies.
Objectives/Aims: This is a retrospective descriptive study which investigates and compares the sensitivity and specificity of US and MRI scan in detecting full and partial thickness rotator cuff tears.
Methods: We reviewed 100 consecutive patients who underwent shoulder arthroscopy and had been preoperatively investigated with an US and/or an MRI scan. 63 patients had an ultrasound, 48 had an MRI and 11 had both done on their affected shoulders.
We calculated the sensitivity and specificity of US and MRI to detect full or partial thickness rotator cuff tears, using the arthroscopic findings as ''gold standard''.
Results: Ultrasonography detected all 26 full thickness tears that were noted intraoperatively (sensitivity of 100%).There were 20 true-negative and 7 false positive ultrasound scans which calculates a specificity of 74%.MRI scan accurately diagnosed 23 of the 24 full thickness rotator cuff tears (sensitivity of 96%).15 true-negative and four false-positive MRI results were recorded (specificity of 79%).
The positive predictive value of the US scan was 79% and 85% for the MRI scan. Respectively the negative predictive value was found to be 100% for the US and 94% for the MRI. Finally the overall accuracy of the ultrasound was calculated as 86.7% in comparison to 88.3% of the MRI scan.
Conclusions: Full-thickness rotator cuff tears can be reliably detected by Ultrasonography and MRI scan with comparable accuracy. The US scan is a dynamic study which is easier tolerated by the patient and can be safely used as the investigation of choice for suspected rotator cuff tears. It is a sensitive and accurate diagnostic tool that allows clinicians to reduce waiting times and overall costs, by also providing important information that guide patients' surgical management.
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