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.
Schneider
Thomas L
TL
Clinic for Orthopedics and Sport Traumatology, Dreifaltigkeitskrankenhaus, Aachenerstr. 445-449, 50933 Cologne, Germany. tom_schneider62@hotmail.com
Schmidt-Wiethoff
Rüdiger
R
Drescher
Wolf
W
Fink
B
B
Schmidt
Joachim
J
Appell
Hans J
HJ
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