HIGH RESOLUTION USG OF ROTATOR CUFF PATHOLOGIES IN CORRELATION WITH MRI

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HIGH RESOLUTION USG OF ROTATOR CUFF PATHOLOGIES IN CORRELATION WITH MRI

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 18

Abstract

BACKGROUND Rotator cuff disease is one of the most common causes of shoulder pain. In addition to history and physical examination, several radiological techniques have been used to detect tears of the rotator cuff. Each has limitations and no clear consensus on the optimum diagnostic study has emerged. The radiological diagnosis of rotator cuff tears has traditionally been performed with arthrography and more recently with non-invasive techniques like ultrasonography and MRI. Aims and Objectives1. To characterise the rotator cuff pathologies on high-resolution Ultrasound. 2. Confirm and correlate the Ultrasound and MRI findings. MATERIALS AND METHODS Study was done in Dept. of Radiology, Shri Siddhartha Medical College, Tumkur. Study period- 30 months. From May 2015 to October 2017. No. of cases- 30. Inclusion- OP and IP patients referred for ultrasound examination with the clinical diagnosis of rotator cuff pathology. Exclusion- Patients who do not undergo MRI examination. Methodology and Technique- High resolution ultrasound using 12 MHz probe was done using standard protocol for rotator cuff evaluation. Findings were noted, and images were saved for the study. MRI was performed using Philips MR scanner 1.5 tesla machine. Standard protocol was followed. Scan was done in all three planes using T1, T2 and FAT-SAT sequences. The images were studied, and findings were co-related. RESULTS Mean age was 46.6 years (range 23 - 76). Maximum patients were above 50 years (33.6%). 20 were males and 10 were females. 18 patients had rotator cuff disorders, 18/30 (60%). Out of 18 patients with rotator cuff disorders, 15 patients had rotator cuff tears 12/20 (60%) and 8 patients had tendinosis 8/20 (40%). The supraspinatus muscle was involved in all cases (100%) without a significant comparable difference between U/S and MR. In our study, diagnostic accuracy of ultrasound in rotator cuff pathologies was 61%. 58.33% for partial thickness tears. The diagnostic accuracy of ultrasound in detection of complete tear of the supraspinatus muscle was 92.14%, while that of MRI was 100%. CONCLUSION U/S and MRI are valid diagnostic modalities in detecting, characterising and discriminating the rotator cuff disorders with no significant comparable difference in detecting full thickness supraspinatus tears. U/S has many challenges in patients with partial thickness and interstitial tears. MRI is more sensitive and has highest diagnostic accuracy in detecting rotator cuff tears as compared to USG and clinical diagnosis.

Authors and Affiliations

Roopa H. N, Sanket M Kotnis, Balakrishna Shetty

Keywords

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EP ID EP418133
DOI 10.14260/jemds/2018/510
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