Comparison of Complementary Exams in the Diagnosis of Rotator Cuff Injuries

Abstract

The aim of this study was to evaluate the accuracy of simple radiography, ultrasound and magnetic resonance imaging (MRI) in diagnosing rotator cuff injuries, comparing their findings with open or arthroscopic surgery findings. Methods: Protocols of the Shoulder and Elbow Surgery Service for patients undergoing surgical treatment for rotator cuff injuries diagnosed by means of radiography, ultrasound and/or MRI between 2002 and 2007 were evaluated. Based on the data gathered, we analyzed the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of these complementary examinations, compared with the findings during the surgical procedures. Results: This study included 147 patients with a mean age of 46.09 years. All the patients had undergone a radiography examination, 101 had undergone ultrasound examination and 72 had undergone MRI. We found sensitivity of 13.8%, specificity of 2.6% and accuracy of 30% with radiography; sensitivity of 57.6%, specificity of 29.6% and accuracy of 51.4% with ultrasound; and sensitivity of 86.6%, specificity of 22.2% and accuracy of 63.3% with MRI. Conclusion: Radiography was found to be a specific examination when the mirror sign was present. MRI and ultrasound were shown to be reliable methods with high accuracy for diagnosing rotator cuff injuries.

Lesão do manguito rotador e obesidade: Uma avaliação demográfica e metabólica

“… 24 25 26 To close the diagnosis of complete or partial RC injury, a musculoskeletal ultrasound examination was performed bilaterally in all patients, using the protocol established by Selvaraj et al 27 Ultrasonography is a reliable method, presenting high accuracy in the diagnosis of RC lesions. 28 …”

“…[24][25][26] To close the diagnosis of complete or partial RC injury, a musculoskeletal ultrasound examination was performed bilaterally in all patients, using the protocol established by Selvaraj et al 27 Ultrasonography is a reliable method, presenting high accuracy in the diagnosis of RC lesions. 28 The physical examinations of the volunteers were performed by a physician with residency in orthopedics and traumatology, specialized in shoulder/elbow surgery, at the endocrinology and obesity outpatient clinic of our institution. The imaging examinations were performed by a physician specialized in musculoskeletal ultrasonography, with a diploma issued by Associação Médica Brasileira in the field of radiology and diagnostic imaging.…”

“…O exame físico envolveu a avaliação dos dados antropométricos de peso e estatura, realizados com os pacientes sem sapatos e vestindo roupas leves (à partir desses dados, o IMC individual foi calculado), circunferência abdominal, e testes clínicos norteadores de diagnóstico da lesão do MR (testes de Jobe, de Patte, e de Gerber), realizados conforme suas descrições. 24 25 26 Para fechar o diagnóstico de lesão completa ou parcial do MR, o exame ultrassonográfico musculoesquelético foi realizado bilateralmente, em todos os pacientes, utilizando o protocolo estabelecido por Selvaraj et al 27 A ultrassonografia é um método confiável, que apresenta elevada acurácia no diagnóstico das lesões do MR. 28 …”

Musculoskeletal ultrasound-guided physical therapy in hemiplegic shoulder pain

“…It has up to 92% sensitivity and 94% specificity in detecting complete rotator cuff tear, [ 14 ] and prior studies have established and validated application of high-frequency probe MU in the diagnosis of rotator cuff tear and rotator cuff injury. [ 15 ] El-Kouba et al [ 16 ] confirmed the accuracy and sensitivity of MU in diagnosing abnormal rotator cuffs. Research into the ultrasonographic characteristics of the shoulder in stroke patients revealed that ultrasonography was helpful in detecting soft tissue lesions in these patients.…”