Diagnostic Accuracy of High Resolution Ultrasound in Communicating Rotator Cuff Tears

Background/Objective: High resolution ultrasound is performed in the investigation of rotator cuff pathology. However, there are various reports in the literature regarding the diagnostic accuracy of ultrasound. The purpose of our study was to compare the diagnostic accuracy of ultrasound with multislice computed tomography arthrography (CT arthrography). Patients and Methods: We prospectively studied sixty-four consecutive patients with rotator cuff pathology diagnosed by ultrasound (35 men and 29 women; age range, 35-75) who underwent preoperative multislice CT arthrography of the shoulder from February 2006 to January 2008. Full-thickness and communicating partial-thickness tears of the supraspinatus, infraspinatus, subscapularis tendons as well as the abnormalities of the long head of the biceps tendon were assessed. Results: The right shoulder was involved in 44 patients. The supraspinatus tendon was the most frequently involved either by full-thickness (n=50) or partial-thickness (n=29) tears. Ultrasound correctly identified full-thickness rotator cuff tears in 84 % of cases with a good positive predictive value (83%). The sensitivity and specificity of ultrasound in the detection of partial-thickness tears were 76% and 46%, respectively. These percentages significantly increased with the presence of joint effusion (77% vs 70%) and joint and subacromial/subdeltoid bursal effusion (80% vs 67%). Conclusion: Ultrasound allows an accurate diagnosis of full-thickness tears. The diagnostic performance of ultrasound in the assessment of partial-thickness tears increases when a joint effusion or double effusion is present.