- Discussion:
- surgically demonstratable full thickness RTC tears are present in about
1/5 elderly patients;
- MRI studies have been published which note a much higher prevalence of RTC tear;
- complete supraspinatus tears may occur in upto 20% after age 32 yrs;
- after age 40 years of age, approximately 30% of patients will have cuff tears, and
after age 60 yrs, there will be cuff tears in upto 80% of patients;
- in the study by SA TeefeyMD et al, 100 consecutive shoulders in 98 patients with shoulder
pain who had undergone preoperative US and subsequent arthroscopy were identified;
- arthroscopic diagnosis was a full-thickness rotator cuff tear in sixty-five shoulders, a
partial-thickness tear in fifteen, rotator cuff tendinitis in twelve, frozen shoulder
in four, arthrosis of the acromioclavicular joint in two, and a superior labral tear
and calcific bursitis in one shoulder each;
- ultrasonography correctly identified all 65 full-thickness rotator cuff tears (a sensitivity of 100 percent);
- there were seventeen true-negative and three false-positive ultrasonograms (a specificity of 85 percent);
- overall accuracy was 96 percent;
- size of the tear on transverse measurement was correctly predicted in 86 percent of the shoulders with a full-thickness tear;
- ultrasonography detected a tear in ten of fifteen shoulders with a partial-thickness tear that was diagnosed on arthroscopy.
- 5 of 6 dislocations and seven of eleven ruptures of the biceps tendon were identified correctly;
- References
Ultrasonography of the Rotator Cuff. A Comparison of Ultrasonographic and Arthroscopic Findings in One Hundred Consecutive Cases*
SA Teefey MD et al.
JBJS Apr 2000, Vol 82-A, No 4. 498
