MR Imaging of Rotator Cuff Tears: Correlation with Arthroscopy
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 5
Abstract
Introduction: Rotator cuff tears are quite common and can cause significant disability. Magnetic Resonance Imaging (MRI) has now emerged as the modality of choice in the preoperative evaluation of patients with rotator cuff injuries, in view of its improved inherent soft tissue contrast and resolution. Aim: To evaluate the diagnostic accuracy of routine MRI in the detection and characterisation of rotator cuff tears, by correlating the findings with arthroscopy. Materials and Methods: This prospective study was carried out between July 2014 and August 2016 at the AJ Institute of Medical Sciences, Mangalore, Karnataka, India. A total of 82 patients were diagnosed with rotator cuff injury on MRI during this period, out of which 45 patients who underwent further evaluation with arthroscopy were included in this study. The data collected was analysed for significant correlation between MRI diagnosis and arthroscopic findings using kappa statistics. The sensitivity, specificity, predictive value and accuracy of MRI for the diagnosis of full and partial thickness tears were calculated using arthroscopic findings as the reference standard. Results: There were 27 males and 18 females in this study. The youngest patient was 22 years and the oldest was 74 years. Majority of rotator cuff tears (78%) were seen in patients above the age of 40 years. MRI showed a sensitivity of 89.6%, specificity of 100%, positive predictive value of 100% and negative predictive value of 83.3% for the diagnosis of full thickness rotator cuff tears. For partial thickness tears, MRI showed a sensitivity of 100%, specificity of 86.6%, positive predictive value of 78.9% and negative predictive value of 100%. The accuracy was 93.1% for full thickness tears and 91.1% for partial thickness tears. The p-value was less than 0.01 for both full and partial thickness tears. There was good agreement between the MRI and arthroscopic findings, with kappa value of 0.85 for full thickness tears and 0.81 for partial thickness tears. Conclusion: MRI revealed high sensitivity and specificity for the diagnosis of rotator cuff tears with accuracy of 93.1% for full thickness tears and 91.1% for partial thickness tears. MRI provides useful information about the size and extent of the tear, involvement of adjacent structures, presence of muscle atrophy and tendon retraction, all of which have important therapeutic and prognostic implications.
Authors and Affiliations
Gururaj Sharma, Sudarshan Bhandary, Ganesh Khandige, Utkarsh Kabra
Keywords
Related Articles
- EP ID EP343777
- DOI 10.7860/JCDR/2017/27714.9911
- Views 97
- Downloads 0
Classification of Root Canal Configurations: A Review and a New Proposal of Nomenclature System for Root Canal Configuration
ABSTRACT Pulp space is complex, root canals may divide and rejoin. In the simplest form each root with one canal and single apical foramen is not observed always, other canal configurations are present which exit the roo...
Survey of Diagnostic Criteria for Fetal Distress in Latin American and African Countries: Over Diagnosis or Under Diagnosis?
Letter to Editor
Primary Hypothyroid and Secondary Adrenal InsufficiencySearching the Missing Link
Images in Medicine
Cut-off Levels of CRP to Predict Outcomes in Patients with Influenza Infection
ABSTRACT Introduction: Seasonal flu is an acute viral infection caused by an influenza virus. People with weakened or suppressed immune system and people with existing chronic disorders are at a greater risk of serious c...
Prediction of the Dimensions of the Spiritual Well-Being of Students at Kermanshah University of Medical Sciences, Iran: The Roles of Demographic Variables
Introduction: Spiritual well-being is one of the aspects of wellbeing which organize the physical, psychological, and social aspects. Given the outstanding and unique roles of students in society, providing spiritual wel...