Symptomatic partial rotator cuff tears: diagnostic performance of ultrasound and magnetic resonance imaging with surgical correlation.
BACKGROUND
The painful shoulder is a relatively common clinical entity that may be attributed to a variety of pathologies, including partial rotator cuff tears. Conservative treatment or surgical intervention may be offered, depending on the extent of the partial tear and the degree of patient discomfort.


OBJECTIVE
To apply ultrasound (US) imaging in order to evaluate the prevalence of partial rotator cuff tears in patients with painful shoulders.


METHODS
Fifty-six patients (17 men, 39 women; mean age 53.7 years) were included in the study, with symptomatic impingement syndrome of the shoulder after having failed to respond to conservative treatment. All patients underwent US and magnetic resonance imaging (MRI) scans prior to surgical intervention.


RESULTS
Arthroscopy or mini-open surgery revealed 53 cases with partial tears of the rotator cuff and three with extensive tendinopathy. Both imaging modalities detected successfully 44 cases of partial tears of the supraspinatus tendon. US imaging yielded a sensitivity of 95.6%, a specificity of 70%, an accuracy of 91%, and a positive predictive accuracy of 93.6%. The corresponding values for MRI were 97.7%, 63.6%, 91%, and 91.7%, respectively.


CONCLUSIONS
US imaging can be considered almost equally effective in detecting partial tears of the rotator cuff compared to MRI, particularly located in the area of the supraspinatus tendon. MRI may be reserved for doubtful or complex cases, in which delineation of adjacent structures is mandatory prior to surgical intervention.
Vlychou
M
M
Department of Radiology, University Hospital of Larissa, Medical School of Thessaly, Larissa, Greece. mvlychou@med.uth.gr
Dailiana
Z
Z
Fotiadou
A
A
Papanagiotou
M
M
Fezoulidis
I V
IV
Malizos
K
K
D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery; D020069:Shoulder Pain / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D013708:Tendon Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography