Rotator Cuff Imaging - Ian McDermott 14/11/2000

(MRI vs ULTRASOUND)

Introduction

Arthrography is the gold standard in imaging of the rotator cuff. Reported accuracy of 98 - 99% [Mink, Radiology 1985; 157: 621]. But = invasive.

Disadvantage of US is that it is very operator dependent and does not allow visualisation of the entire cuff. US has been reported to have sensitivity and specificity > 90% [Crass, J Clin Ultrasound 1988; 16(5): 313].

MRI takes a long time, is expensive may be unsuccessful in very large or claustrophobic patients (7% unable to have MRI due to claustrophobia [Burke AJR 1989 - see below]).

Brief MINIACI THE AMERICAN JOURNAL OF SPORTS MEDICINE 1995
Author Miniaci A, Dowdy PA, Willits KR, Vellet AD University of Western Ontario, London, Canada
Title Magnetic Resonance Imaging Evaluation of the Rotator Cuff Tendons in the Asymptomatic Shoulder
Reference Am. J. Sports Med. (1995), 23; 2: 142 - 145
Summary In 30 MRI scanned asymptomatic shoulders. For the supraspinatus tendon, NONE were normal, 23% appeared to have 'partial tears', None showed complete tears. Similar results for infraspinatus and subscapularis. All teres minor tendons were normal. SUMMARY - non-enhanced MRI may be of little value in investigating suspected PARTIAL tears.
Critique Blinded. Senior musculoskeletal radiologist. 'Not told that patients were asymptomatic.'



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