Imaging of Rotator Cuff Pathology - Is Ultrasound as Good as Mri

Abstract

Aim of this study is to compare the diagnostic accuracy of ultrasound versus MRI in detecting rotator cuff pathology. Rotator cuff pathology involves group of disorder, which progresses from bursitis to tendinitis to partial tear and full thickenss tear. The most commonly affected tendon is the supraspinatus tendon. In our prospective study of 35 patients as initial ultrasound was followed by MRI sensitivity, specificity and accuracy for diagnosis of full thickness tear of supraspinatus when USG was compared to MRI was 100%, whereas sensitivity, specificity and accuracy of diagnosing partial thickness tear using ultrasound compared to MRI are 100%, 78% and 84%. There is no significant p value difference on comparing ultrasound with MRI on detecting tears. Ultrasound and MRI showed almost similar diagnostic accuracy in associated findings like tendon retraction, muscle atrophy, bursal effusion. Ultrasound also has additional value of dynamic evaluation, which is useful in evaluating subacromial and subcoracoid impingement. Modality choice for the evaluation of rotator cuff pathology should be based on several factors like availability, patient preference and clinical information being sought. The high resolution sonography is an attractive screening modality for rotator cuff in patients presenting with painful shoulder. A well performed ultrasound examination in most cases obviates the need for more invasive diagnostic tests like arthrography and cumbersome and expensive MRI examinations. KEYWORDSRotator Cuff, Magnetic Resonance Imaging, Ultrasound, Shoulder. HOW TO CITE THIS ARTICLE: INTRODUCTIONThe shoulder joint is an incongruous ball and socket joint without any fixed axis of rotation, which has wider range of motion in multiple planes, hence stability is compromised for mobility. To compensate for this unstable bone anatomy the shoulder is protected anteriorly, posteriorly and superiorly by a capsule and rotator cuff tendons. These tendons are subjected to wear and tear during day-to-day activities giving rise to shoulder pain. The rotator cuff muscles are namely supraspinatus, infraspinatus, subscapularis and teres minor. The common disorders involving the rotator cuff tendons include impingement, tendinopathy and tear.It is a dynamic process leading on from degeneration to tears in these tendons. The most commonly affected rotator cuff tendon is the supraspinatus. The factors which aid on to this progress includes age, occupation, trauma, acromion type,