Correlation of clinical examination, ultrasound, magnetic resonance imaging and arthroscopy as diagnostic tools in shoulder pathology

Abstract

<p class="abstract"><strong>Background:</strong> Shoulder pathologies can cause significant pain, discomfort, and affect the activity of daily living. The aim of this study was to compare the efficacy of clinical examination, ultrasound, magnetic resonance imaging (MRI) with shoulder arthroscopy in diagnosing various shoulder pathologies, considering shoulder arthroscopy as the gold standard tool.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, comparative study conducted over 35 patients, between 18-75 years of age presenting with chronic shoulder pain or instability of more than 2 months duration. All patients were examined clinically, followed by high resolution ultrasound, MRI, arthroscopy of the affected shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sensitivity and specificity of ultrasonography (USG) for diagnosing full thickness tear was 100% each and for MRI was 88% and 100% respectively. For subacromial impingement USG had sensitivity of 66.67%, specificity of 94.12%, positive predictive value of 50% and negative predictive value of 88.89%. For rotator cuff tear USG had sensitivity of 92.86%, specificity of 50%, positive predictive value of 81.25% and negative predictive value of 75% considering shoulder arthroscopy as gold standard.</p><p class="abstract"><strong>Conclusions:</strong> USG and MRI both are sensitive techniques for diagnosing of rotator cuff pathologies. USG has high accuracy in diagnosing partial thickness tears as compare to MRI. MRI proved to be superior in estimation of site and extent of tear. Considering shoulder arthroscopy as gold standard, it can be reserved for patients with suspicious of USG/MRI findings or those who may need surgical intervention simultaneously.</p>

Role of Magnetic Resonance Imaging and Ultrasonography in Evaluation of Chronic Non osseous Shoulder Pain.

“…Ultimately, MRI was more sensitive and specific for most underlying pathologies than ultrasound. The specificity and sensitivity for supraspinatus impingement by ultrasound was 58.3% and 78.6 % respectively, NPV 81.5% and PPV of 53.9% with accuracy 72.5% which in line with Biswas et al [3] who showed that, ultrasound had sensitivity of 66.67%, specificity of 94.12%, positive predictive value of 50% and negative predictive value of 88.89%.…”

“…Shoulder pain is of osseous and non-osseous origins. Rotator cuff, acromioclavicular joint [ACJ] and glenohumeral joint [GHJ] conditions are among the commonest nonosseous causes of shoulder pain [3] . Causes of shoulder pain usually affected by patient age.…”

Accuracy of High Resolution Ultrasonography for Diagnosis of Rotator Cuff Tears Con-sidering Magnetic Resonance Imaging as Gold Standard

“…Matthieu et al 13 showed 65% specificity for USG which is low as compared to our study. Roy et al [14][15][16][17] reported 91% sensitivity and 86% specificity for USG. For USG, the finding of his study is consistent with our study.…”