Today's News

Friday, March 2, 2001

Ultrasound images more accurate for rotator cuff tears

Evaluation of the rotator cuff in the persistently painful postsurgical shoulder is challenging, investigators said Thursday in scientific paper 98. Magnetic resonance imaging (MRI) has been the preferred modality, however accuracy rates are lower than those seen with a nonoperated shoulder. Their study found ultrasound is a highly accurate imaging modality for evaluating the integrity of the rotator cuff in the postoperative shoulder.

Fifty consecutive patients who underwent both a high-resolution ultrasound exam and subsequent shoulder arthroscopy were retrospectively reviewed. There were 33 previous rotator cuff repairs using suture anchors, 16 previous subacromial decompressions and one instability repair.

Ultrasounds were performed by one of two radiologists and a single surgeon performed all arthroscopic evaluations. Findings were then correlated. Ultrasound correctly diagnosed 44 of 50 patients. At surgery there were 24 full-thickness rotator cuff tears (FTRCT) and 26 intact rotator cuffs were identified. Ultrasound correctly identified 22 of 24 patients with FTRCT (true positive). Of the 26 patients with intact rotator cuffs, 22 were correctly identified by ultrasound (true negative) and four were read as FTRCT (false positive). Two patients with a FTRCT was read as having an intact cuff (false negative).

The study found sensitivity and specificity of ultrasound for rotator cuff integrity in the postoperative shoulder was 92 percent and 85 percent, respectively. The total accuracy was 89 percent.

Coauthors of the study are William D. Prickett, MD; Leesa M. Galatz, MD; Ryan Calfee, BS; Sharlene Teefey, MD; William D. Middleton, MD; and Ken Yamaguchi, MD, from the shoulder and elbow service, department of orthopaedic surgery and the Mallinckrodt Institute of Radiology, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, Mo.

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Last modified 15/February/2001 by IS