Accuracy of Ultrasonography (US) and Magnetic Resonance Imaging (MRI) in Detection of Rotator Cuff Tears in District General Hospital

Background: Rotator cuff tears (RCTs) represent a significant proportion of shoulder diseases, hence they are a frequent cause of patient visits in shoulder clinics. However, the diagnosis of rotator cuff tears is controversial. Investigation of cuff tears is based on ultrasonography (US) and magnetic resonance imaging (MRI). Both modalities have been in use for decades, and their advantages and limitations are known. A recent Cochrane review of the subject suggested that US and MRI both performed well with respect to full thickness rotator cuff tears (FTT). However, they were less accurate with respect to partial thickness tears (PTT). The aim of this study is to assess the accuracy of US and MRI in diagnosing rotator cuff tears.

Material/methods: This is a retrospective analysis of a cohort of 255 patients who underwent shoulder arthroscopy. Of them, 125 patients had preoperative US, and 130 had preoperative MRI. The imaging results were compared with arthroscopic findings for patient.

Results: After calculating sensitivity, specificity, positive prediction value (PPV), and negative prediction value, we found no statistically significant difference between US and MRI in detection of rotator cuff tears of any type (RCT) or FTT. However, US is more specific in detecting PTT compared to MRI (P=0.00008) but with no significant difference in other parameters.

Conclusions: We concluded that US and MRI both have similar accuracy in diagnosing RCT of any sort and FTT. However, US is more specific than MRI in detecting PTT. In our institute, we now recommend US as the investigation of choice for diagnosing rotator cuff tears.