European Journal of Molecular & Clinical Medicine

Background - Shoulder pain is one of the commonest conditions encountered in our
orthopedic department. Accurate diagnosis is a must before undertaking any treatment. Since
clinical diagnosis cannot make an accurate diagnosis, radiological investigation is necessary
to know the exact cause of shoulder pain. There are a wide range of invasive and noninvasive
modalities that can be used to investigate these patients. Ultrasound examination is a
highly specific and sensitive modality in comparison with MRI. High-resolution real-time
USG has shown to be a cost-effective means of investigation of rotator cuff pathologies. With
recent advances with USG, results of imaging of shoulder joint pathologies are as similar or
in some cases more precise in the diagnosis than MRI.
Methods - Prospective analysis of 52 patients presenting with shoulder pain were included in
our study. A pre-formed written consent is also taken. All patients underwent a thorough
clinical examination, USG of the affected shoulder with comparison of the opposite side and
MRI of the affected shoulder for comparison.
Results - Ultrasound is equivalent in detection of rotator cuff tears in comparison with MRI.
MRI outscores ultrasound in detection of labral tears, cartilaginous lesions and subtle bony
lesions. USG examination can be used as the first line of investigating a case of shoulder pain
as it is inexpensive, real time and allows for comparison with the opposite side. MRI can be
used as a confirmatory tool.

Background: The shoulder arthroscopy is the gold standard of reference in most of the shoulder pathologies including Rotator cuff tears. However, it is an invasive surgical procedure with associated risks of surgery and anaesthesia. The objective of the present study is to find out how accurately the rotator cuff pathologies can be diagnosed by these imaging tests.
Aims and Objectives: To compare the Ultrasonography, MRI findings with the Arthroscopic findings of Rotator cuff pathology of the shoulder.
Materials and Methods: All patients in whom the history and clinical examination is suggestive of Rotator cuff pathology were included in the study. Patients were evaluated using high resolution Ultrasound (HRUS) Philips HD-11, Germany and 1.5-Tesla MRI [1.5 Tesla, GE, Excite HD and USA]. Ultrasonographic and MRI examination is performed by a single radiologist experienced in musculoskeletal ultrasonography and MR Imaging. A Real time high resolution USG imaging and MRI of the shoulder was performed in a standardized fashion and subsequently with therapeutic or diagnostic arthroscopy on the symptomatic shoulder. Results were analyzed.
Results: Considering arthroscopy as the final gold standard of investigation, out of the 24 patients studied, five (20.8%) had rotator cuff tendinosis/tendinopathy, four (16.6%) had PT RCT, twelve (50%) had FT RCT while the remaining three (12.6%) had normal rotator cuff. The average delay between the MRI examination and arthroscopic surgery was 6 days (range 0-27 days) but in one case, it was as long as 117 days. A total of five (20.8%) patients were in the age group < 40 years while another five (20.8%) were between 40-50 years age group. A majority of eleven (45.8%) patients were between 50-60 years old while three (12.6%) were above 60 years.
Conclusion: It should be noted that following USG of the shoulder performed by a dedicated radiologist, MRI offers little additional value, with regard to the detection of rotator cuff tears.

Introduction: The rotator cuff disorders constitute the most common cause of shoulder
pathologies. Ultrasonography and MRI are widely used in evaluating various shoulder
pathologies. USG of shoulder is simple, cheap, fast and non-invasive imaging technology
for detection of rotator cuff and non- rotator cuff abnormalities. In this study we have
assessed the usefulness of USG in diagnosing the shoulder pathologies and have correlated
with the MRI.
Aim: Evaluation of a patient with shoulder pathology with ultrasonography as the initial
line of imaging technique as compared to MRI, assessing the accuracy of ultrasonography
in diagnosing shoulder joint pathologies, especially rotator cuff abnormalities, using MRI
as a reference standard and correlating findings wherever possible.
Materials and Methods: Hundred patients were studied prospectively over a period of two
years. Study subjects included both men and women in all age groups with suspected
shoulder pathology, suspected to have musculo-tendinous origin. All patients underwent
USG evaluation of the shoulder joint followed by MRI of the affected shoulder.
Results: USG showed a sensitivity of 85%, specificity of 100%, PPV of 100% and NPV of
97% in diagnosing full thickness tear of rotator cuff using MRI as reference. For partial
thickness tears, it showed a sensitivity of 71%, specificity of 69%, PPV of 82% and NPV of
54%. Overall accuracy of USG in detection of any tear of rotator cuff with MRI as
reference was 82%. The strength of agreement between USG and MRI for the diagnosis of
any tear of rotator cuff is considered to be ‘substantial’ in our study (Kappa=0.635).
Conclusion: USG showed comparable results to MRI in assessment of rotator cuff
abnormality and should be used as first line of investigation in patients presenting with
shoulder pathologies. It proved to have high sensitivity and specificity for full thickness
tears with relatively less sensitivity and specificity in detection of partial thickness tear.