Characterization of Rotator Cuff Tears: Ultrasound Versus Magnetic Resonance Imaging

Okoroha, Kelechi R.; Mehran, Nima; Duncan, J. M.; Washington, Travis; Spiering, Tyler; Bey, Michael J.; Holsbeeck, Marnix van; Moutzouros, Vasilios

doi:10.3928/01477447-20161013-04

Cited by 42 publications

(38 citation statements)

References 52 publications

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“…Posterosuperior rotator cuff tears were diagnosed using MRI findings. In the previous general-population studies 2 , 27 , the existence of a rotator cuff tear was determined by ultrasound instead of MRI, which has higher interobserver reliability 57 . In addition, MRI findings are also more useful for diagnosing subscapularis tendon tears, so in the current study, we were able to exclude subscapularis tendon tears 58 .…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Atraumatic Posterosuperior Rotator Cuff Tears

Park

Gwark

et al. 2018

The Journal of Bone and Joint Surgery

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Background:Certain metabolic factors have been proposed as risk factors for a posterosuperior rotator cuff tear. Although metabolic syndrome is of increasing concern in industrialized societies, little information exists regarding its association with posterosuperior rotator cuff tears. The purpose of this study was to determine the risk factors for an atraumatic posterosuperior rotator cuff tear, including metabolic factors and metabolic syndrome.Methods:This study involved 634 subjects (634 shoulders) drawn from a cohort of rural residents. Posterosuperior rotator cuff tear diagnoses were based on magnetic resonance imaging (MRI) findings. Logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for various demographic, physical, and social factors, including age, sex, dominant-side involvement, body mass index (BMI), and participation in manual labor; the comorbidities of diabetes, hypertension, dyslipidemia, thyroid dysfunction, ipsilateral carpal tunnel syndrome, and metabolic syndrome; and the serum metabolic parameters of serum lipid profile, glycosylated hemoglobin A1c, and level of thyroid hormone. Two multivariable analyses were performed: the first excluded metabolic syndrome while including diabetes, hypertension, BMI, and hypo-high-density lipoproteinemia (hypo-HDLemia), and the second included metabolic syndrome while excluding the formerly included variables.Results:Age, BMI, waist circumference, dominant-side involvement, manual labor, diabetes, hypertension, metabolic syndrome, ipsilateral carpel tunnel syndrome, HDL (high-density lipoprotein), and hypo-HDLemia were significantly associated with posterosuperior rotator cuff tears in univariate analyses (p ≤ 0.035). In the first multivariable analysis, age (OR. 1.86 [95% CI, 1.47 to 2.35]), BMI (OR, 1.09 [95% CI, 1.02 to 1.18]), dominant-side involvement (OR, 2.04 [95% CI, 1.38 to 3.01]), manual labor (OR, 9.48 [95% CI, 5.13 to 17.51]), diabetes (OR, 3.38 [95% CI, 1.98 to 5.77]), and hypo-HDLemia (OR, 2.07 [95% CI, 1.30 to 3.29]) were significantly associated with posterosuperior rotator cuff tears (p ≤ 0.019). In the second multivariable analysis, age (OR, 1.85 [95% CI, 1.48 to 2.31]), dominant-side involvement (OR, 1.83 [95% CI, 1.26 to 2.67]), manual labor (OR, 7.71 [95% CI, 4.33 to 13.73]), and metabolic syndrome (OR, 1.98 [95% CI, 1.35 to 2.91]) were significantly associated with posterosuperior rotator cuff tears (p ≤ 0.002).Conclusions:The metabolic factors of diabetes, BMI, hypo-HDLemia, and metabolic syndrome were significant independent factors associated with the development of posterosuperior rotator cuff tears.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Factors Associated with Atraumatic Posterosuperior Rotator Cuff Tears

Park

Gwark

et al. 2018

The Journal of Bone and Joint Surgery

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“…However, if the ultrasound is negative and there is ongoing clinical concern, MRI should be considered which is keeping in line with current algorithms used for rotator cuff imaging [8]. Although ultrasound has similar sensitivity and specificity compared to MRI when diagnosing some types of supraspinatus tendinopathy, MRI is shown to be better at accurately depicting the lesion size, medial retraction and degree of muscle fatty infiltration [16]. Partial thickness tears were where most of the discrepancy between ultrasound and MRI findings were in our study.…”

Section: Discussionmentioning

confidence: 88%

Development of supraspinatus imaging guidance for primary care physicians with a focus on patient selection

et al. 2020

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Background: Primary care physicians frequently encounter patients with supraspinatus pathology and face a difficult task of managing this subset of patients using limited imaging resources. The purpose of this study was to develop a guidance that could help primary care physicians choose appropriate imaging tests judiciously for patients with suspected supraspinatus pathology. Methods: The imaging reports of one hundred patients who underwent ultrasound and MRI for suspected supraspinatus tendinopathy were retrospectively assessed. The supraspinatus tendon was recorded as intact, partial tear (articular or bursal), or full-thickness tear (focal or complete width). The agreement between imaging modalities was then evaluated using factors such as pathology type and age. Results: There was agreement between modalities in 48/100 patients (Kappa statistic = 0.30). The consistency varied with type of pathology: intact tendons by ultrasound had 55.8% agreement with MRI, partial sided bursal tears 50%, partial sided articular tears 25%, and full-thickness focal tears 33.3%. Full-thickness complete-width tears had a much better agreement with MRI at 90.9%. Age was also significant, with increased disagreement between ultrasound and MRI in patients over 50 years old. Conclusions: Our data showed that ultrasound findings correlated well with MRI in patients under 50 years of age and also in patients with full-thickness supraspinatus tears. We recommend that primary care physicians may consider using ultrasound as the initial test in younger patients and in patients with suspected full supraspinatus tears, based on clinical exam, with MRI as an option for further evaluation to quantify supraspinatus muscle atrophy. These patient selection recommendations will help promote mindful utilization of scarce resources.

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“…In fact, although MSUS provided high accuracy in the detection of rotator injuries compared to MRI; many clinicians prefer MRI as preoperative imaging than ultrasound because ultrasound provides less information regarding the morphology of torn ends of cuff muscles and the exact size and extent of tear [9]. Okoroha et al [10], retrospectively studied ultrasound and MRI of 144 patients who underwent arthroscopic repair of rotator cuff and showed that there is a greater difference between the two modalities in the measurement of tear size and retraction status and concluded that ultrasound is the imaging modality for detection of rotator cuff tear and MRI should be done for surgical planning of large tears. Also, Sipola et al…”

Section: Discussionmentioning

confidence: 99%

Role of Ultrasonography in Evaluation of Rotator Cuff Muscle Injury

Mohamed¹,

Ali²,

Mohamed³

et al. 2019

Sohag Medical Journal

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The term "rotator cuff" referred to the four muscles supporting the humeral head originating from the scapular anterior and posterior aspects with their tendons inserted in the lesser and greater tuberosity. These muscles are the subscapularis; supraspinatus; infraspinatus and teres minor. Objective: The aim of this study was to evaluate the accuracy of musculoskeletal ultrasound in the detection of rotator cuff injuries as compared to MRI as a gold standard technique. Patient and methods: This study included 30 patients presented to the radiology department of Sohag University, with shoulder pain for evaluation of the rotator cuff integrity. Ultrasonography and non-enhanced MRI were done to all patients by 2 different radiologists being blind to the results of the other examination to minimize the bias. The age of our cases had two peaks, one at the age of 50 and a smaller one at around the age of 30. Results: The mean age was 42.07years, with ages ranged from 25 to 60 years.10 were males and 20 were females. In our study the sensitivity statistics of MSUS compared to MRI were as follows: sensitivity (96.6%); specificity (100%); positive predictive value (100%); negative predictive value (50%) and accuracy (98.3%). Conclusion: Ultrasound has comparable accuracy with MRI for identifying rotator cuff injuries. Ultrasound can be used as screening modality since it is easily available and cost-effective.

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Characterization of Rotator Cuff Tears: Ultrasound Versus Magnetic Resonance Imaging

Cited by 42 publications

References 52 publications

Factors Associated with Atraumatic Posterosuperior Rotator Cuff Tears

Factors Associated with Atraumatic Posterosuperior Rotator Cuff Tears

Development of supraspinatus imaging guidance for primary care physicians with a focus on patient selection

Role of Ultrasonography in Evaluation of Rotator Cuff Muscle Injury

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