title: Accuracy of preoperative MRI in the diagnosis of subscapularis tears.
abstract: BACKGROUND
  The subscapularis has received little attention in the orthopedic literature, although such lesions are evident in up to 40 % of arthroscopies. An accurate diagnosis is important in clinical practice, as it affects both patient prognosis and surgical planning. The aim of this study was to evaluate the accuracy of preoperative MRI for the identification of subscapularis tears. Our secondary aim involved the identification of factors that may be predictive for the presence of subscapularis tears.
  
  
  METHODS
  This retrospective case series included patients undergoing shoulder arthroscopy due to rotator cuff injury. MRI was performed using a 1.5 T unit, and the results were assessed by a musculoskeletal radiologist. The findings were compared to those of arthroscopic inspection.
  
  
  RESULTS
  A total of 93 shoulders were analyzed. The overall accuracy was 82 %, with values of 79 % for partial tears and 89 % for full-thickness tears. Tears requiring repair demonstrated an accuracy of 88 %. Infraspinatus tears, fatty degeneration of the subscapularis, biceps instability and age were identified as predictive factors for the presence of injury.
  
  
  CONCLUSIONS
  MRI of the shoulder demonstrated an accuracy of 82 % for the diagnosis of subscapularis tears. The accuracy values for partial and full-thickness tears were 79 and 89 %, respectively.
  
  
  METHODS
  III, development of diagnostic criteria with universally applied reference-nonconsecutive patients.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333, 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Malavolta
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333, 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil. drjorgeassuncao@gmail.com.
authors.forename: Jorge H
authors.initials: JH
authors.lastname: Assunção
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333, 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Cesar L B
authors.initials: CL
authors.lastname: Guglielmetti
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333, 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Felipe F
authors.initials: FF
authors.lastname: de Souza
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333, 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Mauro E C
authors.initials: ME
authors.lastname: Gracitelli
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333, 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bordalo-Rodrigues
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos 333, 3rd floor, Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil.
authors.forename: Arnaldo A
authors.initials: AA
authors.lastname: Ferreira Neto
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000601:surgery; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D012680:Sensitivity and Specificity
keywords: Accuracy; Arthroscopy; MR imaging; Rotator cuff surgery; Rotator cuff tear; Subscapularis tendon