Online ISSN: 2515-8260

Role of MRI and high resolution ultrasound in rotator cuff tears

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Role of MRI and high resolution ultrasound in rotator cuff tears

Abstract

Background: The shoulder joint is a ball and socket variety of joint with wide range of movements in multiple planes where stability is compromised for mobility. The muscles and tendons are subjected to severe strain resulting in tears. Rotator cuff disease is one of the most common causes of shoulder pain. In addition to history and physical examination, several radiological techniques have been used to detect tears of the rotator cuff. Each has limitations and no clear consensus on the optimum diagnostic study has emerged. The radiological diagnosis of rotator cuff tears has traditionally been performed with arthrography and more recently with non-invasive techniques like ultrasonography and MRI. Aims and objectives: Evaluation of role of MRI in rotator cuff injuries, evaluation of role of high resolution ultrasound in rotator cuff injuries. Correlation of clinical and high resolution ultrasound findings with MRI findings. Materials and Methods: In our study we took over the analysis of 32 patients with clinically suspected rotator cuff injuries were subjected to undergo USG and MRI after thorough history taking and clinical examination. USG was carried out on IU22 Philips machine using a high frequency transducer of 5-17 MHz. The rotator cuff tendons, muscles, ACJ, joint cavity and bursae were examined in various positions. Dynamic examination of shoulder were also carried out for impingement. MRI was performed on 1.5 Tesla MRI scanner, using a dedicated surface coil for shoulder. Results: Majority of the rotator cuff tears were seen in patients above 50 yrs of age (40%) with males affected more than females (M:F ratio-5:1), dominant arm (83.3%) affected more than the non-dominant arm with 75% of the cases with history of trauma showing rotator cuff tears depicting the fact that increasing age, male gender, dominant arm and history of trauma are predisposing factors for rotator cuff tears. Pain was the most common clinical complaint (43.8%) followed by inability to do overhead abduction (25%) in our study in patients with rotator cuff tears. Partial tears (68.8%) were more common than the full thickness tears (23.33%). Among the partial tears most common were articular surface tears in approx 85% followed by bursal tears in 10% and intrasubstance tears in 5%. 75% of the patients with peribicipital tendon fluid had rotator cuff tears showing significant association between peribicipital tendon fluid and rotator cuff tears. Conclusion: In our study, USG proved to be highly accurate in evaluating partial tendon tear and complete tear. Thus, USG is almost equally effective as MRI for rotator cuff tears but not for other pathologies. Because of high resolution and better soft tissue assessment, MRI should be used to evaluate overall joint including labral, capsular or ligamentous pathologies before planning any surgery. MRI is more sensitive and has highest diagnostic accuracy in detecting rotator cuff tears as compared to USG and clinical diagnosis.

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