European Journal of Molecular & Clinical Medicine

Abstract

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.