Magnetic resonance imaging reproducibility for rotator cuff partial tears in patients up to 60 years

Abstract

Background Magnetic resonance imaging (MRI) is the gold standard in diagnosing rotator cuff pathology; however, there is a lack of studies investigating the reliability agreement for supraspinatus partial-thickness tears among orthopaedic surgeons and musculoskeletal (MSK) radiologists. Methods Sixty digital MRI scans (1.5 Tesla) were reviewed by two orthopaedic shoulder surgeons, two MSK radiologists, two fellowship-trained shoulder surgeons, and two fellowship-trained orthopaedic surgeons at two distinct times. Thirty-two scans of partial-thickness tears and twenty-eight scans of the supraspinatus tendon with no tears were included. Supraspinatus tendonosis and tears, long head of the biceps pathology, acromial morphology, acromioclavicular joint pathology and muscle fatty infiltration were assessed and interpreted according to the Goutallier system. After a four-week interval, the evaluators were asked to review the same scans in a different random order. The statistical analyses for the intra- and interobserver agreement results were calculated using the kappa value and 95% confidence intervals. Results The intraobserver agreement for supraspinatus tears was moderate among the MSK radiologists (k = 0.589; 95% CI, 0.446–0.732) and the orthopaedic shoulder surgeons (k = 0.509; 95% CI, 0.324–0.694) and was fair among the fellowship-trained shoulder surgeons (k = 0.27; 95% CI, 0.048–0.492) and the fellowship-trained orthopaedic surgeons (k = 0.372; 95% CI, 0.152–0.592). The overall intraobserver agreement was good (k = 0.627; 95% CI, 0.576–0.678). The intraobserver agreement was moderate for biceps tendonosis (k = 0.491), acromial morphology (k = 0.526), acromioclavicular joint arthrosis (k = 0.491) and muscle fatty infiltration (k = 0.505). The interobserver agreement results for supraspinatus tears were fair and poor among the evaluators: the MSK radiologists and the orthopaedic shoulder surgeons had the highest agreement (k = 0.245; 95% CI, 0.055–0.435). Conclusions In this sample of digital MRI scans, there was an overall good intraobserver agreement for supraspinatus partial tears; however, there were also poor and fair interobserver agreement results. The evaluators with higher levels of experience (the orthopaedic shoulder surgeons and the MSK radiologists) demonstrated better results than evaluators with lower levels of experience. Electronic supplementary material The online version of this article (10.1186/s12891-019-2760-4) contains supplementary material, which is available to authorized users.

Research Trends on the Rotator Cuff Tendon: A Bibliometric Analysis of the Past 2 Decades

“…At present, magnetic resonance (MR) imaging is considered the gold standard for diagnosing rotator cuff injuries. 43 Many researchers focused on sonography and MR arthrography between 2000 and 2005. In a meta-analysis that was in the top 100 articles, the authors 9 found that MR arthrography had higher sensitivity and specificity than did MR imaging and ultrasound and the diagnostic value of MR imaging was similar to ultrasound in diagnosing rotator cuff injuries.…”

High-frequency Quantitative Ultrasound Imaging of Human Rotator Cuff Muscles: Assessment of Repeatability and Reproducibility

“…The participants were chosen to represent extreme ends of the range of rotator cuff pathology typically encountered in clinical practice. MRI was used to determine muscle status, which is recognized as the gold standard, 1,37 but is much slower, less convenient and less cost-effective compared with US. On the routine B-mode images, both radiologists in this study identified the fatty degeneration of the rotator cuff muscles in the injured participant.…”

Aging‐Related Rotator Cuff Tears: Molecular Mechanisms and Implications for Clinical Management

“…CT or MRI imaging is commonly utilized for the clinical assessment of rotator cuff muscle atrophy. [13,14] The muscle atrophy observed in rotator cuff tears can be attributed to both the insufficient mechanical stimulation resulting from tendon detachment and inadequate innervation in rotator cuff tendinopathy. [15][16][17][18] Extensive clinical evidence has consistently demonstrated the detrimental effects of muscle atrophy on the exacerbation of tear size, poorer surgical outcomes, and increased occurrence of retears following repair.…”