The Value of Ultrasound Performed by a Physiatrist in the Detection of Supraspinatus Tendon Tears Diagnosed Using Magnetic Resonance Imaging
Keywords:
supraspinatus tendon tear, ultrasound, magnetic resonance imaging, physiatristAbstract
Objectives: To assess the sensitivity and specificity of shoulder ultrasound (US) performed by a physiatrist for detecting supra-spinatus tendon tears using magnetic resonance imaging (MRI) as a reference standard.
Study design: Diagnostic research with retrospective data collection.
Setting: The rehabilitation medicine outpatient clinic, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima Province, Thailand.
Subjects: Patients over 18 years old with shoulder pain clinically suspected of having a rotator cuff tear who underwent shoulder US and MRI.
Methods: The US was performed by a physiatrist who had completed a 1-month clinical observational course of the musculo-skeletal US training program. The MRIs were accomplished by two general radiologists. A physiatrist, who was not an ultrasono-grapher, reviewed all patients’ data from the hospital records. A cross-table comparison was conducted between US assessment and MRIs of the supraspinatus tendon. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. A total of 65 patients were included in the study.
Results: The US performed by a physiatrist showed a sensitivity of 84.4% and specificity of 100% in detecting all-type supraspinatus tendon tears. The sensitivity and specificity in detecting full-thickness tears were 88.5% and 82.9%, respectively, and 55.3% and 89.7%, respectively, in detecting partial-thickness tears.
Conclusions: Shoulder US by a trained physiatrist showed high sensitivity and specificity for detecting supraspinatus tears diagnosed by MRI. Trained clinicians who are new to musculoskeletal ultrasound could use this method in the clinical-based evaluation of supraspinatus tendon tears for initial diagnosis and management.
References
Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis [Internet]. 1998 Sep [cited 2021 Oct 11];57:649-55. Available from: https://pubmed.ncbi.nlm.nih.gov/9924205 doi: 10.1136/ard.57.11.649
Redondo AL, Chamorro MG, Jiménez RJ, López TP, Ridao FC. Relationship between chronic pathologies of the supraspinatus tendon and the long head of the biceps tendon: systematic review. BMC Musculoskelet Disord [Internet]. 2014 Nov [cited 2021 Nov 9];15:377-87. Available from: https://pubmed.ncbi.nlm.nih.gov/25408141 doi: 10.1186/1471-2474-15-377
Lenza M, Buchbinder R, Takwoingi Y, Johnston RV, Hanchard NC, Faloppa F. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Db Syst Rev [Internet]. 2013 Sep [cited 2021 Sep 18];3:1-134. Available from: https://pubmed.ncbi.nlm.nih.gov/24065456 doi: 10.1002/14651858.CD009020.pub2
Jesus JO, Parker L, Frangos AJ, Nazarian LN. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. Am J Roentgenol [Internet]. 2009 May [cited 2021 Sep 15];192:1701-7. Available from: https://www.ajronline.org/doi/epdf/10.2214/AJR.08.1241 doi: 10.1136/bjsports-2014-094148
Farooqi AS, Lee A, Novikov D, Kelly AM, Li X, Kelly JD, et al. Diagnostic accuracy of ultrasonography for rotator cuff tears: a systematic review and meta-analysis. Orthop J Sports Med [Internet]. 2021 Apr [cited 2022 Jan 30];9:1-12. Available from: https://pubmed.ncbi.nlm.nih.gov/34660823 doi: 10.1177/23259671211035106
Sirasaporn P, Musculoskeletal Ultrasound Diagnosis for Normal Shoulder. J Thai Rehabil Med [Internet]. 2017 [cited 2022 Jan 24];27(3):77-81. Available from: https://www.rehabmed.or.th/main/wp-content/uploads/2017/12/L-430.pdf doi: 10.14456/jtrm.2017.17
Teefey SA, Hasan SA, Middleton WD, Patel M, Wright RW, Yamaguchi K. Ultrasonography of the rotator cuff. A comparison of ultrasonographic and arthroscopic findings in one hundred consecutive cases. J Bone Joint Surg [Internet]. 2000 Apr [cited 2022 Feb 6];82(4):498-504. Available from: https://pubmed.ncbi.nlm.nih.gov/10761940
Iannotti JP, Ciccone J, Buss DD, Visotsky JL, Mascha E, Cotman K, et al. Accuracy of office-based ultrasonography of the shoulder for the diagnosis of rotator cuff tears. J Bone Joint Surg [Internet]. 2005 Jun [cited 2022 Feb 8];87(6):1305-11. Available from: https://pubmed.ncbi.nlm.nih.gov/15930541 doi: 10.2106/JBJS.D.02100
Co S, Bhalla S, Rowan K, Aippersbach S, Bicknell S. Comparison of 2- and 3-dimensional shoulder ultrasound to magnetic resonance imaging in a community hospital for the detection of supraspinatus rotator cuff tears with improved worktime room efficiency. Can Assoc Radiol J [Internet]. 2012 Aug [cited 2022 Jan 1];63:170–6. Available from: https://pubmed.ncbi.nlm.nih.gov/21975160 doi: 10.1016/j.carj.2011.02.003
Cole B, Twibill K, Lam P, Hackett L, Murrell GA. Not all ultrasounds are created equal: general sonography versus musculoskeletal sonography in the detection of rotator cuff tears. J Shoulder Elb Surg [Internet]. 2016 Aug [cited 2022 Jan 8];8:250–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023055 doi: 10.1177/1758573216658800
Kurz AZ, Kelly MJ, Hackett L, Murrell GAC. Effect of surgeon-sonographer interaction on ultrasound diagnosis of rotator cuff tears: a five-year cohort study in 775 shoulders. J Shoulder Elb Surg [Internet]. 2016 Jul [cited 2022 Feb 12];25:1385–94. Available from: https://pubmed.ncbi.nlm.nih.gov/27424254
Guo LP, Wang WM, Wang YH, Liu YP, Yu XB, Ma XJ. Ultrasound in assessment of supraspinatus tendon injury: correlation with arthroscopy. Chinese Med J [Internet]. 2016 Feb [cited 2022 Mar 12];129:361–3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799583 doi: 10.4103/0366-6999.174486
Dinnes J, Loveman E, McIntyre L, Waugh N. The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review. Health Technol Assess [Internet]. 2003 Oct [cited 2022 Jun 25];7:1-166. Available from: https://pubmed.ncbi.nlm.nih.gov/14567906 doi: 10.3310/hta7290
Kumnerddee W, The use of ultrasound to diagnose shoulder pain. RTA Med J [Internet]. 2015 Jul [cited 2021 Dec 19];68:135-42. Available from: https://he02.tci-thaijo.org/index.php/rtamedj/article/download/60934/50189
Martín-Hervás C, Romero J, Navas-Acién A, Reboiras JJ, Munuera L. Ultrasonographic and magnetic resonance images of rotator cuff lesions compared with arthroscopy or open surgery findings. J Shoulder Elb Surg [Internet]. 2001 Sep [cited 2022 Mar 10];10:410–5. Available from: https://pubmed.ncbi.nlm.nih.gov/11641696 doi: 10.1067/mse.2001.116515
Waldt S, Bruegel M, Mueller D. Rotator cuff tears: assessment with MR arthrography in 275 patients with arthroscopic correlation. Eur J Radiol [Internet]. 2007 Feb [cited 2022 Mar 11];17:491–98. Available from: https://pubmed.ncbi.nlm.nih.gov/16969638 doi: 10.1007/s00330-006-0370-7
Teefey SA, Middleton WD, Payne WT, Yamaguchi K. Detection and measurement of rotator cuff tears with sonography: analysis of diagnostic errors. Am J Roentgenol [Internet]. 2005 Jun [cited 2021 Oct 4];184:1768–73. Available from: https://pubmed.ncbi.nlm.nih.gov/15908528 doi: 10.2214/ajr.184.6.01841768
Rutten MJ, Jager GJ, Blickman JG. US of the rotator cuff: pitfalls, limitations, and artifacts. Radiographics [Internet]. 2006 Mar [cited 2021 Oct 26];26:589–604. Available from: https://pubmed.ncbi.nlm.nih.gov/16549619 doi: 10.1148/rg.262045719
Yazigi JA, Nicolao FA, Matsunaga FT, Archetti Netto N, Matsumoto MH, Tamaoki MJS. Sensitivity and specificity of ultrasonography in diagnosing supraspinatus lesions: a prospective accuracy diagnostic study. Sao Paulo Med J [Internet]. 2018 Jul [cited 2022 Feb 12];136:292–7. Available from: https://pubmed.ncbi.nlm.nih.gov/30110078 doi: 10.1590/1516-3180.2018.0069170418
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