The significance of subacromial arthrography to verify partial bursal-side rotator cuff ruptures.
BACKGROUND
The purpose of this study was to verify a partial bursa-side rupture of the rotator cuff (RC) using different imaging techniques with special emphasis on the validity of a specific method of subacromial arthrography (SAA).


METHODS
Patients (n=92, mean age 53.8 years) with a subacromial impingement syndrome underwent sonography, magnetic resonance imaging (MRI), and SAA. All diagnostic results were checked by subsequent arthroscopic surgery.


RESULTS
Of 31 surgically verified ruptures, 17 showed a partial rupture located towards the bursa. These had been detected by MRI and ultrasound with a sensitivity of 64% and 41%, respectively, while SAA as a diagnostic tool yielded a sensitivity of 82%. In 14 cases of complete RC ruptures, all imaging techniques had a similar sensitivity of 86-93%.


CONCLUSIONS
It appears that SAA is an adequate and valid diagnostic tool for the detection of partial bursa-sided RC ruptures. Ultrasound and MRI showed a comparably lower sensitivity. It is therefore concluded that SAA has clear advantages in the diagnosis of this defect with the consequence that open surgical techniques can be avoided.
Clinic for Orthopedics and Sport Traumatology, Dreifaltigkeitskrankenhaus, Aachenerstr. 445-449, 50933 Cologne, Germany. tom_schneider62@hotmail.com
Thomas L
TL
Schneider
Rüdiger
R
Schmidt-Wiethoff
Wolf
W
Drescher
B
B
Fink
Joachim
J
Schmidt
Hans J
HJ
Appell
D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000473:pathology; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000473:pathology