Sonographic evaluation of rotator cuff muscles injuries keeping MRI shoulder as gold standard.

Abstract

Objective: To evaluate the diagnostic performance of ultrasonography (USG) compared to magnetic resonance imaging (MRI) in diagnosing rotator cuff muscles injuries. Study Design: Cross-sectional, Validation study. Setting: Department of Radiology, Combined Military Hospital (CMH), Gujranwala, Pakistan. Period: April 2023 to September 2024. Methods: A total of 91 patients aged 18 to 75 years, referred for imaging due to clinical suspicion of rotator cuff muscle injury were analyzed. All patients underwent shoulder USG, as well as MRI within a two-week interval, and findings were compared. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of USG were calculated using MRI findings as the reference standard. Concordance between USG and MRI findings was assessed using Cohen’s kappa coefficient (κ). A p-value < 0.05 was considered significant. Results: Among the 91 patients, 48 (52.7%) were female. The mean age was 48.85±14.85 years. USG analyzing full-thickness rotator cuff tears demonstrated sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 68.4%, 97.2%, 86.7%, 92.1%, and 91.2%, respectively, with substantial agreement (κ=0.712, p<0.001). For partial-thickness rotator cuff tears, USG showed sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 89.7%, 90.3%, 81.3%, 94.9%, 90.1%, respectively, with substantial agreement (κ=0.778; p<0.001).USG detecting rotator cuff tendinopathy, yielding a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 96.2%, 96.9%, 92.6%, 98.4%, 96.7%, respectively, with very substantial agreement (κ=0.920; p<0.001). Conclusion: This study demonstrated high-resolution ultrasound as a reliable and effective modality for diagnosing rotator cuff muscle injuries.