Sensitivity and specificity of ultrasonography in diagnosing supraspinatus lesions
a prospective accuracy diagnostic study
Keywords:
Rotator cuff, Magnetic resonance imaging, UltrasonographyAbstract
BACKGROUND: This study was designed to define the accuracy of shoulder ultrasonography for diagnosing supraspinatus tendon tears. This examination is routinely used by orthopedists and may do away with the need for other examinations for diagnosing these tendon injuries. The aim of this study was to evaluate the sensitivity and specificity of shoulder ultrasonography for diagnosing supraspinatus tendon injuries, using magnetic resonance imaging as the reference. DESIGN AND SETTING: Prospective accuracy study at a single center: the Shoulder and Elbow Surgery Clinic of the Department of Orthopedics and Traumatology. METHODS: Shoulder ultrasonography was performed on 80 patients of both genders, over 18 years of age, with complaints of shoulder pain and clinically suspected supraspinatus tendon lesions. Jobe’s test and a full can test were performed. In addition, they underwent magnetic resonance imaging in a 3.0-tesla machine, as the reference standard. The examinations were performed and interpreted by radiologists. RESULTS: Ultrasonography showed sensitivity of 36.3% and specificity of 91.7% for supraspinatus tears overall: sensitivity of 25.8% and specificity of 91.8% for partial tears and sensitivity of 46.2% and specificity of 100% for full-thickness tears. Ultrasonography showed high accuracy for diagnosing full-thickness tears: 91.3%. The p-values were 0.003 for tears overall, 0.031 for partial tears and < 0.001 for full-thickness tears. CONCLUSIONS: Ultrasonography showed low sensitivity for detecting supraspinatus tears, but high specificity for both partial and full-thickness tears.
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References
Vecchio P, Kavanagh R, Hazleman BL, King RH. Shoulder pain in a community-based rheumatology clinic. Br J Rheumatol. 1995;34(5):440-2. PMID: 7788173.
Lewis JS. Rotator cuff tendinopathy. Br J Sports Med. 2009;43(4):236-41. PMID: 18801774; doi: 10.1136/bjsm.2008.052175.
Wani Z, Abdulla M, Habeebullah A, Kalogriantis S. Rotator cuff tears: Review of epidemiology, clinical assessment and operative treatment. Trauma. 2016;18(3):190-204. doi: 10.1177/1460408615596770.
Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 2010;19(1):116-20. PMID: 19540777; doi: 10.1016/j.jse.2009.04.006.
Al-Shawi A, Badge R, Bunker T. The detection of full thickness rotator cuff tears using ultrasound. J Bone Joint Surg Br. 2008;90(7):889-92. PMID: 18591598; doi: 10.1302/0301-620X.90B7.20481.
Alavekios DA, Dionysian E, Sodl J, Contreras R, Cho Y, Yian EH. Longitudinal analysis of effects of operator experience on accuracy for ultrasound detection of supraspinatus tears. J Shoulder Elbow Surg. 2013;22(3):375-80. PMID: 23312821; doi: 10.1016/j.jse.2012.09.017.
Chauhan NS, Ahluwalia A, Sharma YP, Thakur L. A Prospective Comparative Study of High Resolution Ultrasound and MRI in the Diagnosis of Rotator Cuff Tears in a Tertiary Hospital of North India. Pol J Radiol. 2016;81:491-7. PMID: 27800039; doi: 10.12659/PJR.897830.
Lenza M, Buchbinder R, Takwoingi Y, et al. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database Syst Rev. 2013;(9):CD009020. PMID: 24065456; doi: 10.1002/14651858.CD009020.pub2.
Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review. Health Technol Assess. 2003;7(29):iii,1-166. PMID: 14567906.
Roy JS, Braën C, Leblond J, et al. Diagnostic accuracy of ultrasonography, MRI and MR arthrography in the characterisation of rotator cuff disorders: a systematic review and meta-analysis. Br J Sports Med. 2015;49(20):1316-28. PMID: 25677796; doi: 10.1136/bjsports-2014-094148.
Chang CY, Wang SF, Chiou HJ, et al. Comparison of shoulder ultrasound and MR imaging in diagnosing full-thickness rotator cuff tears. Clin Imaging. 2002;26(1):50-4. PMID: 11814754.
Iannotti JP, Ciccone J, Buss DD, et al. Accuracy of office-based ultrasonography of the shoulder for the diagnosis of rotator cuff tears. J Bone Joint Surg Am. 2005;87(6):1305-11. PMID: 15930541; doi: 10.2106/JBJS.D.02100.