A comparative study of ultrasonography and arthrography in evaluation of the rotator cuff.
Fifty patients with signs and symptoms of chronic impingement syndrome and/or rotator cuff tear were evaluated with shoulder arthrograms and ultrasonography. Ninety asymptomatic shoulders of a comparable age had ultrasonography to serve as a control group. All controls had normal ultrasonograms with no hypoechoic or sonolucent areas. The 50 symptomatic shoulder patients had the following: 28 had a normal arthrogram with either normal ultrasonograms or buckling of the supraspinatus tendon; eight had normal arthrograms, but ultrasonography indicated a thin (less than 4 mm) irregular supraspinatus tendon; 11 had complete rotator cuff tears visualized on both arthrography and ultrasonography (nine of these 11 patients had surgery confirming complete tears in all); two had a false-positive sonogram, and one had a false-negative sonogram. Thus, the ultrasonography's overall positive predictive value to detect a full-thickness rotator cuff tear was 85%, its negative predictive value was 97%, its sensitivity was 92%, and its specificity was 95%. Real-time ultrasonography is a diagnostically sensitive and specific noninvasive method to evaluate patients with shoulder impingement syndrome, leading to the recommendation that it be used as a primary imaging technique to obviate or supplement arthrography in evaluating rotator cuff disease. However, static ultrasonographic pictures, without real-time ultrasonography as a supplement, were not helpful.
Drakeford
M K
MK
Orthopaedic Surgery Service, Dwight David Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650.
Quinn
M J
MJ
Simpson
S L
SL
Pettine
K A
KA
D000328:Adult; D000368:Aged; D001175:Arthrography; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012785:Shoulder Joint; D014463:Ultrasonography