Assessing the Diagnostic Accuracy of Ultrasound and MRI for Rotator Cuff Tears in a Tertiary Care Hospital in Chennai

Abstract

Introduction: Rotator cuff disease (RCT) is a common cause of shoulder pain and dysfunction, with varying severity from minor partial-thickness tears to large retracted full-thickness injuries. Risk factors for RCTs include age, trauma, dominant arm, diabetes, smoking, hypercholesterolemia, and heredity. Ultrasound (US) and magnetic resonance imaging (MRI) are noninvasive imaging methods used to diagnose RCT and related shoulder pathologies.US is more widely available, less expensive, and allows for dynamic examination and evaluation of muscular contraction.US has been proven highly accurate in identifying or excluding full-thickness tears, with a combined sensitivity and specificity of 0.95 and 0.96. While US is less sensitive than MRI for identifying partial-thickness tears, it is as sensitive as MRI for diagnosing full-thickness tears. Objectives: To compare the ultrasound for the detection of RCT with respect to MRI. To identify tendinopathic changes, PTT and FTT of RC and to assess sensitivity and Specificity of ultrasound to against MRI, as benchmark Methods: A total of thirty cases with RCT were included. All patients aged above 18 years with clinical suspicious of RCT MRI Procedure: Based on inclusion criteria with informed consent MRI shoulder was taken with the required MR sequences MRI Analysis: Look for rotator cuff muscle or tendon injury or any collection around shoulder joint and assess the degree and type of tear. Ultrasound Scanning: Followed by ultrasound scanning of shoulder joint was done Comparison of Findings: Compare USG findings with respect to MRI Results: In this study, the mean age of the participants was 41.5 years, with a predominance of male individuals. Ultrasound (USG) findings indicated abnormalities in the subscapularis, supraspinatus, infraspinatus, and teres minor in 30%, 6.7%, 66.7%, and 3.3% of cases, respectively. Similarly, magnetic resonance imaging (MRI) revealed abnormalities in the subscapularis, supraspinatus, infraspinatus, and teres minor in 33.3%, 3.3%, 70%, and 3.3% of cases, respectively. Notably, USG demonstrated diagnostic accuracy (DA) of 96.7%, 93.3%, 97.5%, and 90% for no tear, tendinitis, partial thickness tear (PTT), and full thickness tear (FTT), respectively. Conclusions: USG is better in identification of partial RCT followed by no tear , tendinitis and full RCT. Hence in resource limited setting USG can be used as a screening tool to identification of degree of RCT, however , MRI is the choice of preference in fully equipped set ups.