Ultrasonographic evaluation of the rotator cuff and biceps tendon.

Middleton, W D; Reinus, William R.; Totty, William G.; Melson, C. L.; Murphy, William A.

doi:10.2106/00004623-198668030-00020

Cited by 210 publications

(89 citation statements)

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“…Another possible explanation is that there may be fenestrations within the partially torn rotator cuff that allow fluid from the joint to communicate with the bursa. Similarly, we concur with others that the sonographic detection of fluid in the biceps tendon sheath may be associated with the presence of rotator cuff tears [2]. Although this finding has a bower specificity and lower PPV, its recognition should still prompt careful evaluation of the rotator cuff.…”

Section: Resultssupporting

confidence: 90%

Association of sonographically detected subacromial/subdeltoid bursal effusion and intraarticular fluid with rotator cuff tear.

Hollister¹,

Mack²,

Patten³

et al. 1995

American Journal of Roentgenology

120

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RESULTS. Sixty-seven (41%) of the 163 patients had a joint effusion, bursal fluid, or both. Joint effusion alone was seen In 35 patients. Fourteen of these had a normal rotator cuff at surgery, and 21 had a rotator cuff tear (sensitivity, 22%; specIficity, 79%; positive predictive value, 60%). Bursal fluid alone was seen In 10 patIents, seven of whom had a rotator cuff tear (sensitivity, 7%; specificity, 96%; posItive predictive value, 70%). In 22 patients, fluid was seen in both the bursa and the joint; 21 had curgically proved rotator cuff tears (sensitivity, 22%; specificity, 99%; posItive predictive value, 95%). Of the 232 asymptomatlc shoulders, 16 (6.9%) had Isolated joint effuslons, eight (3.4%) had isolated bursab effusions, and four (1 .7%) had both joint and bursal effusions.CONCLUSION. The sonographic finding of lntraarticular fluid alone (without bursal fluid) has both a low sensitivity and a low specificity for the diagnosis of rotator cuff tears. However, the finding of fluid In the subacromial/subdeltold bursa, especially when combined with a joint effusion, Is highly specific and has a high positive predictive value for associated rotator cuff tears. Sonographically detected fluid In both the joint and the bursa is an uncommon finding in asymptomatlc shoulders. The sonographic observation of fluid In the subacromial bursa, either Isolated or cornbined with a joint effusion, should prompt a careful evaluation of the supraspinatus tendon for tear.

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Section: Resultssupporting

confidence: 90%

Association of sonographically detected subacromial/subdeltoid bursal effusion and intraarticular fluid with rotator cuff tear.

Hollister¹,

Mack²,

Patten³

et al. 1995

American Journal of Roentgenology

120

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“…Thus, it is possible that some patients in their study may have had chronic RCT or acute extension of chronic tears-in particular, those with nonvisualized cuffs. Other studies have reported the sonographic finding of nonvisualization of the cuff as indicative of a massive RCT, [16][17][18][19][20][21] a finding that our data suggested correlates with a chronic tear. Of the five patients in our study with nonvisualization of the rotator cuff, four (80%) had a chronic tear.…”

Section: Discussionsupporting

confidence: 73%

Sonographic differences in the appearance of acute and chronic full-thickness rotator cuff tears.

Teefey

Middleton

Bauer

et al. 2000

Journal of Ultrasound in Medicine

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This study was undertaken to identify differences in the sonographic appearance of acute and chronic full‐thickness rotator cuff tears. The ultrasonograms of 24 patients with an acute rotator cuff tear and 20 with a chronic tear were reviewed for tear size (width), location, and the presence and distribution of fluid. Among these 24 patients, 75% with a midsubstance tear location had an acute tear; 64% of patients with joint or bursal fluid had an acute tear; 80% of patients with a nonvisualized rotator cuff due to a massive tear had a chronic tear; and 73% of patients with no sonographic evidence of bursal or joint fluid had a chronic tear. In conclusion, a midsubstance location and the presence of joint or bursal fluid were more commonly associated with an acute tear. A nonvisualized cuff and the absence of joint and bursal fluid were more commonly observed with a chronic tear.

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“…Proximal ruptures are more common and have been well documented. 3 The long head is affected in 96%, and the short head in 1% of cases. Rupture of the distal biceps tendon is a rare injury constituting about 3% of all ruptures of the biceps tendons; it consists of avulsion of the end of the tendon from the radial tuberosity.4 Some authors have implicated systemic disease processes, such as hyperparathyroidism, in these avulsions.s The diagnosis is suspected when the patient complains of a tearing pain in the antecubital space during a lifting episode.…”

Section: Discussionmentioning

confidence: 99%