Subscapularis tendon tear classification and diagnosis: A systemic review and meta-analysis

Abstract

BackgroundIn the current study, we performed a systematic review and meta-analysis regarding the comparison of accuracy, sensitivity, and specificity of the techniques in diagnosing SSC tendon tears. Also, we performed a systematic review of the classification of SSC tendon tears.MethodsEnglish language, peer-reviewed journal publications from the first date available to March 2022 were extracted by searching PubMed and Web of Science databases. A forest plot was used to graphically show the results of pooled sensitivity, specificity, and accuracy of different diagnostic modalities.ResultsThere were six studies on using MRI to diagnose subscapularis tendon tears, five studies on MRI, four studies on clinical examination, one on ultrasonography, and one on CT arthrography. Pooled sensitivity values for MRI, MRA, clinical examination, ultrasonography, and CT arthrography were 0.71 (CI: 0.54; 0.87), 0.83 (0.77; 0.88), 0.49 (0.31; 0.67), 0.39 (0.29; 0.51), and 0.90 (0.72–0.97), respectively. The pooled specificity values for MRI, MRA, clinical examination, ultrasonography, and CT arthrography were 0.93 (CI: 0.89; 0.96), 0.86 (0.75; 0.93), 0.89 (0.73; 0.96), 0.93 (0.88; 0.96), and 0.90 (0.69; 0.98), respectively. The pooled diagnostic accuracy values for MRI, MRA, clinical examination, ultrasonography, and CT arthrography were 0.84 (CI: 0.80; 0.88), 0.85 (0.77; 0.90), 0.76 (0.66; 0.84), 0.76 (0.70; 0.81), and 0.90 (0.78; 0.96), respectively.ConclusionAccording to our systematic review and meta-analysis, MR arthrography was the most accurate in diagnosing subscapularis tears. MR arthrography was the most sensitive, and MRI and ultrasonography were the most specific in detecting subscapularis tears.

Subscapularis tendon tears: A narrative review

“…Some of these classifications are diagnostic in physical examination, some in ultrasonography, and some in CT arthrography. Yoo and Rhee, Fox and Romeo's, Martetschlager, Lyon, Toussaint, Dierckman classifications are the classifications used in the repair of subscapular tendon tears (10). According to a survey that was conducted among elbow and shoulder surgeons in America in 2023, it was reported that the Lafosse Classification is more appropriate for the most appropriate diagnosis and treatment (11).…”

Magnetic resonance imaging based coracoid process morphology and its associations with isolated subscapularis tendon tears in Chinese patients

“…Subscapularis tendon is the strongest and largest tendon of the rotator cuff, which plays an essential role in the motion and stability of the shoulder. [ 1 ] In general, subscapularis tendon tears as non-traumatic injuries are associated with subcoracoid impingement and intrinsic degeneration. Based on the subcoracoid impingement theory, the pathological mechanism is a structural narrowing in the subcoracoid space.…”