Rotator cuff tear (RCT) is one of the most common causes of shoulder pain. Almost thirty to seventy percent of a patient presenting to the clinics with complain of shoulder pain is most probably due to the rotator cuff tear. The accurate identification of types of tear, including its location and muscles involved is a detrimental factor in the selection of its appropriate management (operative or non-operative therapy), as well as it is also of utmost importance that an orthopedic surgeon acquires a good information regarding the status of the tear prior to the surgery. Usually surgical management is reserved for bursal side tear >3mm in depth, articular side Supraspinatus tear with >7mm exposed bone between the articular surface and intact tendon that has failed conservative therapy and any partial or full thickness tear that has failed the non-operative managements. MRI is a noninvasive technique and due to its excellent soft tissue contrast and multiplanar acquisition which provide optimal assessment of muscles, tendons, hyaline and fibrous cartilage, joint capsule, fat, bursa and bone marrow has gained a popularity as a first choice of investigation for the detection of rotator cuff tear (partial and full-thickness rotator cuff tears). But the accuracy of MRI in detecting the types of tear especially the partial tear is controversial as its interpretation greatly depends on the experience of doctor and the strength of the MRI machines. Reinus et al suggested that MRI was not adequately sensitive or specific for the detection of partial thickness tear. Rutten et al also suggested high accuracy(94%) of MRI in the detection of full thickness tear but comparatively low accuracy(84%) in the detection of partial thickness tear and the overall accuracy of 81% in detection of RCT. In the same study the sensitivity/specificity of MRI in detection of FTT and PTT was shown to be 100%/91% and 67% /86% respectively. Meta analysis of 44 studies in which 2571 shoulder under MRI evaluation of PTT demonstrated a pool sensitivity and specificity of 80%and 95% respectively. But due to several limitations like selection bias, small groups, the strength of MRI less than 3.0 T and consideration of limited parameters have warranted further studies on this topic. The objective of this study is to re-evaluate the diagnostic efficacy of MRI for the detection of PTT and FTT using surgical finding as the 'gold standard ' by improving the limitations of previous studies.
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