Sonography of the shoulder after arthrography (arthrosonography): preliminary results.
OBJECTIVE
The purpose of this study was to verify whether arthrosonography improves diagnostic accuracy in diseases of the shoulder and provides additional information for therapeutic planning, compared with conventional sonography.


METHODS
We prospectively studied 113 consecutive patients with chronic shoulder pain. Sonography was performed before and after arthrography, with the radiologist blinded to the results of arthrography. When a rotator cuff tear was detected sonographically, its type, location, and size were recorded; we also evaluated any changes in the subacromial-subdeltoid bursa and any abnormalities in the biceps tendon sheath. The diagnostic accuracy of conventional sonography and arthrosonography was compared with that of arthrography for rotator cuff tear. Changes in the subacromial-subdeltoid bursa and biceps tendon sheath seen on conventional sonography were also compared with those seen on arthrosonography.


RESULTS
The sensitivity and specificity of conventional sonography in the diagnosis of rotator cuff tear were 86% (25/29) and 95% (80/84), respectively; for arthrosonography, the values were 97% (28/29) and 95% (80/84), respectively. The differences in sensitivity and specificity for the 2 sonographic techniques were not statistically significant (p > 0.05). The accuracy in localizing the tear was also not significantly different between the 2 sonographic techniques. Synovial proliferation was more easily detected with arthrosonography than it was with conventional sonography in the subacromial-subdeltoid bursa (p < 0.01) and in the biceps tendon sheath (p < 0.0001).


CONCLUSIONS
Our preliminary results suggest that although arthrosonography was not superior to conventional sonography in the diagnosis of rotator cuff tears, it may provide a better assessment of the size of tears and additional information about synovial proliferation in the subacromial-subdeltoid bursa and the biceps tendon sheath.
Lee
Hak Soo
HS
Department of Radiology, College of Medicine, Hanyang University, #17 Haengdang-Dong, Seungdong-Gu, Seoul 133-792, South Korea.
Joo
Kyung-Bin
KB
Park
Choong Ki
CK
Kim
Young Sun
YS
Jeong
Woo Kyeong
WK
Kim
Yong Soo
YS
Park
Dong Woo
DW
Kim
Sun Il
SI
Park
Tae Soo
TS
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000000981:diagnostic imaging*; D020069:Shoulder Pain / Q000000981:diagnostic imaging*; D014463:Ultrasonography