title: Effect of surgeon-sonographer interaction on ultrasound diagnosis of rotator cuff tears: a five-year cohort study in 775 shoulders.
abstract: BACKGROUND
  Ultrasonography for the diagnosis of rotator cuff tears has been a topic of debate for years. The literature shows promising results for the diagnostic utility of ultrasonography for rotator cuff tears. This study assessed the effect of a surgeon-sonographer interaction on the ability of ultrasonography to predict the presence or absence of rotator cuff tears.
  
  
  METHODS
  This study was a temporal cohort analysis of 775 patients to detect the diagnostic accuracy of ultrasonography at predicting a rotator cuff tear. The surgeon-sonographer interaction had three components: (1) presence of an ultrasound machine and ultrasonographer within a shoulder clinic, (2) the ultrasonographer attends shoulder operations, (3) and the ultrasonographer reviews patients preoperatively and postoperatively. Comparisons of 2 variables-presence and size of a tear-were made between the preoperative ultrasonographic findings with arthroscopic findings (gold standard).
  
  
  RESULTS
  The diagnostic utility for the detection of rotator cuff tears by ultrasonography at the start of the study was 93% sensitive and 68% specific, and at the end of the study was 99% sensitive and 93% specific. There was an improvement in the correlation of the ability to estimate the size of rotator cuff tears from ultrasonography to surgery in both full- and partial-thickness tears.
  
  
  CONCLUSIONS
  The surgeon-sonographer interaction improved the diagnostic utility of an office-based ultrasonographer over time, particularly with respect to the overall accuracy of ultrasonography for the detection of rotator cuff tears and for the ability to predict the size of full- and partial-thickness rotator cuff tears.
authors.affiliation: Division of Orthopaedic Surgery, McMaster University, Hamilton, ON, Canada; Orthopaedic Research Institute, University of New South Wales, St George Hospital, Sydney, NSW, Australia.
authors.forename: Adrian Z
authors.initials: AZ
authors.lastname: Kurz
authors.affiliation: Orthopaedic Research Institute, University of New South Wales, St George Hospital, Sydney, NSW, Australia; Orthopaedic Institute of Pennsylvania, Harrisburg, PA, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kelly
authors.affiliation: Orthopaedic Research Institute, University of New South Wales, St George Hospital, Sydney, NSW, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hackett
authors.affiliation: Orthopaedic Research Institute, University of New South Wales, St George Hospital, Sydney, NSW, Australia. Electronic address: murrell.g@ori.org.au.
authors.forename: George A C
authors.initials: GA
authors.lastname: Murrell
mesh_terms: D015331:Cohort Studies; D006801:Humans; D007400:Interprofessional Relations; D016013:Likelihood Functions; D019095:Point-of-Care Systems; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D066231:Surgeons; D014463:Ultrasonography
keywords: Partial-thickness rotator cuff tear; arthroscopic rotator cuff repair; full-thickness rotator cuff tear; office-based ultrasound; surgeon-sonographer interaction; ultrasound diagnosis