The Value of Ultrasound Performed by a Physiatrist in the Detection of Supraspinatus Tendon Tears Diagnosed Using Magnetic Resonance Imaging

Abstract

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.