Diagnostic accuracy of shoulder ultrasound performed by a single operator

Abstract

Both diagnostic ultrasound and magnetic resonance imaging (MRI) are used for investigation of the presence and severity of rotator cuff lesions. There is no consensus as to which is the more accurate and cost-effective study. We sought to examine the sensitivity of ultrasound, when used by one experienced radiologist with modern equipment. We compared the ultrasound and surgical results obtained from 68 patients. Ultrasound showed a sensitivity of 89% and specificity of 100% (Positive Predictive Value 100%) for full-thickness tears, and a sensitivity of 79% and specificity of 94% (Positive Predictive Value 87%) for partial-thickness tears. We found that shoulder ultrasound, in the hands of an experienced radiologist with the use of modern high-resolution equipment, is highly sensitive in differentiating complete tears and partial-thickness tears. Our results are similar to the best published results for MRI and given that ultrasound is significantly cheaper and more available, ultrasound by an experienced radiologist should be considered as a primary diagnostic tool for imaging the rotator cuff.

Does Ultrasound Correlate with Surgical or Histologic Findings in Greater Trochanteric Pain Syndrome? A Pilot Study

“…* Patients were ranked by the difference between recalled preoperative and postoperative pain; all but two patients had a clinically significant improvement in pain levels (p = 0.0002) [6]; HHS = Harris hip score; ODI = Oswestry Disability Index. We found ultrasound had a high positive predictive value for gluteal tendon tears documented at surgery in select patients, which is comparable to that reported for shoulder rotator cuff injury [12,33]. The only other study of ultrasound imaging for GTPS did not report the positive predicative value and was not able to report the sensitivity, because like us, they did not have a surgical control group.…”

Feasibility of ultrasound-guided percutaneous tenotomy of the long head of the biceps tendon-A pilot cadaveric study

“…14 Ultrasonography provides a readily available, accurate, noninvasive, low-cost, and radiationfree diagnostic assessment of the painful shoulder with the added ability for a real-time dynamic assessments. [15][16][17] In addition, there is strong evidence supporting increased accuracy of ultrasound-guided injections in soft tissues and peripheral joints. 18 Furthermore, USguided percutaneous release surgeries showed promising results in various musculoskeletal disorders.…”

Ultrasound measures of supraspinatus tendon thickness and acromiohumeral distance in rotator cuff tendinopathy are reliable

“…A diagnostic US assessment of all participants was undertaken by an experienced musculoskeletal sonographer. For this study, the diagnostic criteria for RC tendinopathy were derived from a combination of existing published criteria . Tendinopathy was diagnosed when there was loss of the normal fibrillar structure of the tendon, with an abnormally hypoechoic appearance.…”

“…For this study, the diagnostic criteria for RC tendinopathy were derived from a combination of existing published criteria. [22][23][24] Tendinopathy was diagnosed when there was loss of the normal fibrillar structure of the tendon, with an abnormally hypoechoic appearance. A partialthickness tear was diagnosed when flattening of the bursal side of the tendon or a distinct hypoechoic defect was seen within or on either surface of the tendon.…”