Accuracy of High Resolution Sonographic Evaluation of Painful Shoulder
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2018, Vol 3, Issue 1
Abstract
Introduction: Shoulder pain is a most common condition that has difficult diagnostic and therapeutic challenges for orthopeadician. This study aimed to show that ultrasound done by a two, experienced radiologist by using sophisticated equipment is specific and sensitive in diagnosing a rotator cuff injury including partial thickness tears. Material and Methods: This was a prospective study done in department of radiology, Fathima Institute of Medical Sciences, Kadapa, Andhra Pradesh. This study was done on 50 patients who were treated by 8 years experienced radiologist by using ultrasound for a period of two years from October 2015 to November 2017. Results: A total of 50 patients were studied who were with shoulder joint pain in which pre-operative ultrasound was done followed by surgery within 10 months by one orthopaedic surgeon. The mean age was 55 years, the highest number of patients were in age range of 51-60 years, which was 16. Time from ultrasound to surgery ranged from 0 to 10 months, i.e. mean was 2.0 months. 25 out of 50 patients were found to have full thickness tears, 12 out of 50 had partial thickness tears and 13 out of 50 patients had bursitis with no evidence of a rotator cuff tears. Ultrasound correctly identified 23 out of 25 full thickness tears. No negatives were observed for ultrasound. It failed to identify 2 full thickness tears, one which was due to florid bursitis and another patient had high grade partial thickness tears with associated moderate tendinopathy. Ultrasound correctly identified 10 out of 12 partial thickness tears. Two reported as partial high grade tears. Two small partial thickness were not seen at sonography. These have been reported as supraspinatus tendinopathy and bursal thickening associated. In this study, ultrasound showed sensitivity of 90%, specificity of 100%; for full thickness tears, positive predictive value was 100% and a sensitivity of 80%; for partial thickness tears, specificity was 95% and PPV was 88%. Conclusion: In assessment of rotator cuff tear, USG can be used as first line of diagnostic tool in investigating shoulder pain in patients. It has high sensitivity and specificity for full thickness tear and partial thickness tear.
Authors and Affiliations
U Syam Sunder Rao, A Ravikumar
Keywords
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