Magnetic resonance imaging of the rotator cuff in destroyed rheumatoid shoulder: comparison with findings during shoulder replacement

Soini, Irma; Belt, Eero A.; Niemitukia, Lea; Mäenpää, Heikki; Kautiainen, Hannu

doi:10.1080/02841850410005354

Cited by 9 publications

(5 citation statements)

References 21 publications

(33 reference statements)

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“…These findings are comparable to those in a similar study in rheumatoid arthritis patients in which the authors found an almost identical degree of accuracy (71% as opposed to 69% in the present study) (Soini et al 2004). Like osteoarthritis, rheumatoid disease also results in significant pathological change in both the glenohumeral joint and the rotator cuff, which probably complicates MRI interpretation.…”

Section: Discussionsupporting

confidence: 91%

“…However, in the setting of glenohumeral OA, it is likely that the significant pathological and anatomical changes contribute to the high false-positive interpretation of full-thickness rotator cuff tears on preoperative MRI by radiologists (Soini et al 2004). Specifically, the presence of humeral head osteophytes, joint effusion, and rotator cuff degeneration and thinning probably make evaluation of the integrity of the rotator cuff difficult (Gupta et al 2004, Soini et al 2004, Roemer et al 2009). …”

Section: Discussionmentioning

confidence: 99%

“…However, the sensitivity, specificity, and positive predictive value of this test may be different in the arthritic shoulder (Gupta et al 2004, Roemer et al 2009). In rheumatoid patients, one study found limited usefulness of MRI in preoperative evaluation of the rotator cuff in patients undergoing shoulder arthroplasty, with an accuracy of only 71% (Soini et al 2004). It has been our experience that radiologists’ interpretations of MRI in the setting of glenohumeral osteoarthritis frequently involve full-thickness rotator cuff tears not seen at the time of surgery.…”

mentioning

confidence: 99%

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Low accuracy of interpretation of rotator cuff MRI in patients with osteoarthritis

Sershon¹,

Mather²,

Sherman³

et al. 2013

Acta Orthopaedica

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BackgroundMagnetic resonance imaging (MRI) is considered to be a valuable tool for the diagnosis of rotator cuff tears in patients with severe glenohumeral osteoarthritis who are indicated for total shoulder arthroplasty (TSA). We determined the sensitivity, specificity, and positive predictive value of MRI in diagnosing rotator cuff tears in such patients.MethodsMRI reports of 100 patients who had completed a shoulder MRI prior to TSA were reviewed to determine the radiologists’ interpretation of the MRI including the diagnosis, presence of a full-thickness cuff tear, and the presence of atrophy and/or fatty infiltration within the rotator cuff muscle bellies. Operative reports were used as a gold standard to determine whether a full-thickness rotator cuff tear was present.ResultsPreoperative MRI reports noted 33 of the 100 patients as having a full-thickness rotator cuff tear, 17 of which had multiple tendon tears. 2 of the 33 patients with full tears on MRI were found to have full-thickness tears at surgery. The sensitivity, specificity, and positive predictive value for MRI detection of full-thickness tears were 100%, 68%, and 6% respectively, with a false-positive rate of 32% and an accuracy of 69%.InterpretationThe study suggests that although MRI is highly sensitive, it has a low positive predictive value and moderately low specificity and accuracy in detecting full-thickness rotator cuff tears in patients with severe glenohumeral osteoarthritis.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Low accuracy of interpretation of rotator cuff MRI in patients with osteoarthritis

Sershon¹,

Mather²,

Sherman³

et al. 2013

Acta Orthopaedica

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“…Regarding the rotator cuff tears and Larsen grades, some previous studies have demonstrated that rotator cuff was the more thinning and torn in the more advanced stage of the Larsen grades 37–39 . Conversely, other reports have reported that there was no significant association between the Larsen grade and the rate of rotator cuff tears 40 .…”

Section: Discussionmentioning

confidence: 99%

Shoulder tenderness was associated with the inflammatory changes on magnetic resonance imaging in patients with rheumatoid arthritis

Shinagawa

Okamura

Yonemoto

et al. 2019

Sci Rep

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The aim of this study was to assess the association between the shoulder tenderness and the inflammatory changes on magnetic resonance imaging (MRI) in the rheumatoid shoulder. Forty-one shoulders of 41 patients with rheumatoid arthritis (RA) were examined. We evaluated synovitis, erosion and bone marrow edema, by counting the numbers of each positive site, and rotator cuff tears on shoulder MRI. The association between the shoulder tenderness and the MRI findings were statistically analyzed. Twenty-three of 41 patients had tenderness in the shoulder joints. There were 20 shoulders (48.8%) with rotator cuff tear, and no significant difference was observed in the prevalence of rotator cuff tear between the tenderness group and non-tenderness group (p = 0.080). There were no significant differences in the demographic data between these two groups. In MRI findings, we found significant difference for the synovitis (p = 0.001) and bone marrow edema (p = 0.021). Synovitis was strongly associated with the shoulder tenderness (OR: 3.996, 95% CI: 1.651–9.671). Synovitis was the factor most associated with shoulder tenderness.

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“…Although CT arthrography was a theoretical possibility, it was not really until the introduction of MRI that the internal joint structures could be studied either as non-enhanced MRI or as MR arthrography. Knee MRI began to be reported in the early 1990s (209,210), shoulder MRI in the late 1990s (206,211), and the Achilles tendon at the same time (212,213). MR arthrography of the shoulder was first reported in 1996 (40).…”

Section: Derangement Of Jointsmentioning

confidence: 99%

The development of musculoskeletal radiology for 100 years as presented in the pages of Acta Radiologica

et al. 2021

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During the last 100 years, musculoskeletal radiology has developed from bone-only radiography performed by everyone to a dedicated subspecialty, still secure in its origins in radiography but having expanded into all modalities of imaging. Like other subspecialties in radiology, it has become heavily dependent on cross-sectional and functional imaging, and musculoskeletal interventions play an important role in tumor diagnosis and treatment and in joint diseases. All these developments are reflected in the pages in Acta Radiologica, as shown in this review.

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Magnetic resonance imaging of the rotator cuff in destroyed rheumatoid shoulder: comparison with findings during shoulder replacement

Cited by 9 publications

References 21 publications

Low accuracy of interpretation of rotator cuff MRI in patients with osteoarthritis

Low accuracy of interpretation of rotator cuff MRI in patients with osteoarthritis

Shoulder tenderness was associated with the inflammatory changes on magnetic resonance imaging in patients with rheumatoid arthritis

The development of musculoskeletal radiology for 100 years as presented in the pages of Acta Radiologica

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