Standard sonography and arthrosonography in the study of rotator cuff tears.
OBJECTIVE
The aim of this study was to evaluate the sensitivity of ultrasonography, integrating standard ultrasound and arthrosonography after injecting a saline solution into the glenohumeral cavity in cases of suspected rotator cuff tears.


METHODS
We prospectively examined 40 patients awaiting shoulder arthroscopy for suspected or diagnosed tears of the rotator cuff. A radiologist, unaware of the pre-operative diagnosis, performed an ultrasound scan on all the patients before and after the injection of saline solution into the glenohumeral cavity. The parameters considered were presence or absence of a rotator cuff injury; type of injury according to Snyder and its extent along the longitudinal and transverse planes; presence or absence of effusion into the articular cavity; subacromial/subdeltoid bursal distension. All the patients underwent arthroscopy either the same day or the day after the ultrasound examination.


RESULTS
Standard sonography showed 26 complete rotator cuff tears (type C according to Snyder), 2 partial tears (type B according to Snyder) and 12 intact rotator cuffs. Arthrosonography detected 31 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs.Arthroscopy identified 32 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Analysis of the results shows that, taking arthroscopy as the gold standard, the sensitivity of normal sonography is 81.2%, whereas that of arthrosonography is 96.8% (p < 0.05).


CONCLUSIONS
On the basis of the data obtained in this study, standard sonography, integrated with the injection of a saline solution into the glenohumeral cavity, considerably increases the diagnostic sensitivity for rotator cuff tears. The authors suggest that arthrosonography can be used in the event of suspected rotator cuff tears, when MRI is contraindicated.
El-Dalati
Ghassan
G
Istituto di Radiologia, Università di Verona, Policlinico G.B.Rossi, Verona, Italy. eldalati@aliceposta.it
Castellarin
Gianluca
G
Martone
Enrico
E
Ricci
Matteo
M
Vecchini
Eugenio
E
Caffarri
Sabrina
S
Fusaro
Michele
M
Pozzi Mucelli
Roberto
R
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging*; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D019534:Shoulder Impingement Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology; D013708:Tendon Injuries / Q000150:complications / Q000000981:diagnostic imaging; D014463:Ultrasonography