Rotator cuff tears: correlation of sonographic and surgical findings.

Hodler, J; Fretz, Christian; Terrier, François; Gerber, Christian

doi:10.1148/radiology.169.3.3055040

Cited by 77 publications

(28 citation statements)

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“…Ultrasound has become a screening method for initial examination of symptomatic shoulders since the development of 5-or 7.5-MHz linear-array transducers permitted high-resolution imaging of the shoulder joint. Several studies have confirmed that high accuracies of over 90 % can be achieved in detection of different disorders of the rotator cuff [11,[14][15][16][17][18]. The major limitations are dependence on operator experience and high risk of artefacts [1,7,18].…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of rotator cuff lesions: comparison of US and MRI on 38 joint specimens

et al. 1997

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IntroductionTreatment of patients with symptoms referable to the rotator cuff depends on location, extent and type of cuff injury. Magnetic resonance imaging and ultrasound are non-invasive imaging methods which are effective for detecting abnormalities of the rotator cuff and biceps tendon [1][2][3][4]. Although both methods are accepted in many routine diagnostic regimens, the results of various studies show a broad range of sensitivity and specificity [5][6][7][8][9][10][11][12]. Statements concerning value and reliability of US and MRI in diagnosis of rotator cuff lesions range from enthusiastic acclaim to critical dismissal. Several factors influence the results of imaging methods in clinical practice. Apart from spatial and contrast resolution, the diagnostic accuracy is determined by the morphological criteria, experience of operator, examination technique, composition of patient collective and reference methods [1].A study on 38 cadaver specimens of shoulder joints was performed to assess the diagnostic value of MRI and US concerning reproducibility of normal joint structures, incidence of artefacts and detection of rotator cuff lesions. Examination on cadaver specimens permits direct comparison of both imaging methods under standardized conditions and verification of diagnostic findings by pathology.Abstract. An experimental study was performed on cadaveric joint specimens of the shoulder to determine the accuracy of US and MRI in diagnosis of abnormalities of the rotator cuff. The value of different morphological criteria was evaluated for discrimination of degeneration as well as partial and complete disruption. A total of 38 surgically exposed specimens of the shoulder joint were examined by US, MRI and pathological methods visualising the tendons of the rotator cuff in same axial and longitudinal orientations. The three imaging modalities were reviewed separately by experienced examiners, respectively, who were blind to other results. Evaluation criteria consisted of signs of shape (thinning, thickening, discontinuity and absence of rotator cuff) and structure (changes in echogenicity in US, increased signal intensity in MRI, tissue changes in pathology). Findings in US and MRI were finally compared with pathology to assess sensitivity and specificity. Pathology demonstrated 4 full-thickness tears, 6 partial-thickness tears, 16 cases with degeneration and 12 normal rotator cuffs. Ultrasound showed pathological signs in all abnormal cuffs, and one MRI report was false negative. Specificity was 67 % in US (4 of 12 cases were false positive) and 100 % in MRI (no abnormal findings in healthy tendons). Discrimination of different pathological disorders of the rotator cuff was reduced in both methods. Using US only 10 of 16 cases of degeneration, 2 of 6 partial tears and 3 of 4 complete tears were correctly defined. Using MRI 13 of 16 degenerations, 3 of 6 partial tears and 3 of 4 complete tears were detected. The MRI technique failed to visualise intratendinous calcifications in all 3 cases. We conclude t...

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Section: Discussionmentioning

confidence: 99%

“…The study was designed to overcome some problems of clinical studies: Firstly, most clinical studies were performed on patients with surgically proven lesions preferring patients with severe lesions [5,11,14,15]. Secondly, intratendinous changes of the rotator cuff cannot be assessed during surgical inspection.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of rotator cuff lesions: comparison of US and MRI on 38 joint specimens

et al. 1997

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“…Shoulder ultrasound has the advantage of being relatively inexpensive and widely available and permits dynamic imaging. However, several papers have reported wide variability in the ability of ultrasound to accurately differentiate between partial‐thickness and full‐thickness rotator cuff tears, particularly between observers 1,3–6 . In the published work there has been reports of diagnostic sensitivities and specificities in excess of 90% 2,7 whereas other publications report sensitivities of less than 50% for the detection of partial‐thickness tears 1,3–5 .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of shoulder ultrasound performed by a single operator

Cullen

Breidahl

Janes

2007

Australasian Radiology

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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.

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“…Other studies have corroborated these data with similar results. 7,15,16,[20][21][22]34,35 Despite these findings, ultrasound has yet to gain the popularity in the United States that it has in Europe. Many clinicians in the United States continue to favor MRI as the radiographic diagnostic modality of choice for evaluation of rotator cuff abnormalities.…”

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confidence: 99%