Detection of rotator cuff tears: the value of MRI following ultrasound.
OBJECTIVE
To evaluate the need for additional magnetic resonance imaging (MRI) following ultrasound (US) in patients with shoulder pain and/or disability and to compare the accuracy of both techniques for the detection of partial-thickness and full-thickness rotator cuff tears (RCT).


METHODS
In 4 years, 5,216 patients underwent US by experienced musculoskeletal radiologists. Retrospectively, patient records were evaluated if MRI and surgery were performed within 5 months of US. US and MRI findings were classified into intact cuff, partial-thickness and full-thickness RCT, and were correlated with surgical findings.


RESULTS
Additional MR imaging was performed in 275 (5.2%) patients. Sixty-eight patients underwent surgery within 5 months. US and MRI correctly depicted 21 (95%) and 22 (100%) of the 22 full-thickness tears, and 8 (89%) and 6 (67%) of the 9 partial-thickness tears, respectively. The differences in performance of US and MRI were not statistically significant (p = 0.15).


CONCLUSIONS
MRI following routine shoulder US was requested in only 5.2% of the patients. The additional value of MRI was in detecting intra-articular lesions. In patients who underwent surgery, US and MRI yielded comparably high sensitivity for detecting full-thickness RCT. US performed better in detecting partial-thickness tears, although the difference was not significant.
Rutten
Matthieu J C M
MJ
Department of Radiology, Jeroen Bosch Ziekenhuis, Nieuwstraat 34, 5211, NL's-Hertogenbosch, The Netherlands. M.Rutten@JBZ.nl
Spaargaren
Gert-Jan
GJ
van Loon
Ton
T
de Waal Malefijt
Maarten C
MC
Kiemeney
Lambertus A L M
LA
Jager
Gerrit J
GJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000473:pathology; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult