Diagnóstico por imagem nas rupturas do manguito rotador (original) (raw)
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Ultrasound in Medicine & Biology, 2010
The aim of this study was to compare the accuracy of ultrasonography (US) and magnetic resonance artrography (MRA) for the detection and measurement of rotator cuff tears, using surgical findings as a standard. A total of 77 consecutive patients with suspected rotator cuff tears were prospectively studied with US and MRA. Rotator cuff tears were identified by US with sensitivity, specificity, positive predictive and negative predictive values of 92%, 45%, 91% and 50%, respectively, and by MRA with values of 97%, 82%, 97% and 82%, respectively. US was not reliable for differentiating between partial and full thickness tears. US and MRA underestimated the tear sizes by an average of 15 mm and 4 mm, respectively. Our results suggest that US could be used as a screening test to confirm a suspected rotator cuff tear. In patients with negative findings, an MRA should be considered for substantiation.
Ultrasonography of symptomatic rotator cuff tears compared with MR imaging and surgery
European Journal of Radiology, 2008
Purpose: To compare the accuracy of ultrasonography and magnetic resonance imaging in the detection of rotator cuff tears. Materials and methods: Ninety-six patients with clinically suspected rotator cuff pathology underwent ultrasonography and magnetic resonance imaging of the shoulder. The findings in 88 patients were compared with arthroscopy or open surgery. Results: Full-thickness tear was confirmed in 57 cases, partial-thickness tear in 30 cases and degenerative changes without tear in 1. In all 57 cases of full-thickness tear and in 28 out of 30 cases of partial-thickness tear the supraspinatus tendon was involved. The accuracy in the detection of full-thickness tears was 98 and 100% for ultrasonography and magnetic resonance imaging, respectively. The accuracy in the detection of bursal or articular partial-thickness tears was 87 and 90% for ultrasonography and magnetic resonance imaging, respectively. Conclusions: In experienced hands ultrasonography should be considered as an accurate modality for the initial investigation of rotator cuff, especially supraspinatus, tears.
Archives of Trauma Research
Original Article introduction The shoulder joint is an elegant anatomic structure held in place by a complex arrangement of muscles, tendons, and ligaments. Rotator cuff is a continuous structure around the shoulder comprised four tendons-subscapularis, supraspinatus, infraspinatus, and teres minor tendons; the long head of the biceps tendon also contributes to the cuff. [1] The requisites for normal cuff functioning are strong, healthy, intact cuff muscles and tendons, normal capsular laxity, and smooth coracoacromial arch. Rotator cuff tears are associated with heavy labor, bony subacromial impingement, tissue degeneration in the aging population, and repeated steroid injections. [2-4] Intrinsic causes lead to degenerative changes in the substance of the rotator cuff with increasing age. The degeneration may result from relative ischemia in the distal portion of the tendon near its insertion site on the humerus. Rotator cuff degeneration may incite secondary proliferative bony changes on the under surface of acromion. Extrinsic cause of rotator cuff disease relates to the mechanical impingement by surrounding structures. The impingement can lead to inflammatory and degenerative changes in the underlying tendons. [1] Rotator cuff tears can be full-thickness tear (FTT) or partial-thickness tear (PTT). Full-thickness tear A FTT is a defect that allows communication between the subacromial-subdeltoid (SASD) bursa and the glenohumeral joint. Partial-thickness tear PTTs are so called because they involve only either substance or surface of the tendon. Joint surface partial tears are more Background: The aim of this study was to assess the accuracy of high-resolution ultrasonography (USG) in the evaluation of rotator cuff tendinopathies and tears with magnetic resonance imaging (MRI) correlation to determine its sensitivity and specificity. Materials and Methods: The prospective study was conducted on 40 patients referred to the Department of Radiology for the evaluation of rotator cuff pathologies over a period of 18 months. All the patients underwent high-frequency USG followed by MRI. Variables such as sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of high-frequency USG and MRI were evaluated. Results: The sensitivity, specificity, NPV, PPV, and accuracy of high-frequency USG in the evaluation of rotator cuff pathologies in comparison to MRI as standard were 90.6%, 87.5%, 96.6%, 70%, and 90%, respectively. Conclusion: High-frequency USG is almost equally sensitive and specific as MRI for the diagnosis of rotator cuff pathologies, and due to its cost-effectiveness, easy affordability, ease of evaluating contralateral shoulder, more patient compliance, noninvasiveness, and wider applications, we recommend it to be used as a primary modality for evaluating rotator cuff. MRI should be performed in case some extra information is required.
Detection of rotator cuff tears: the value of MRI following ultrasound
European Radiology, 2010
Objective To evaluate the need for additional magnetic resonance imaging (MRI) following ultrasound (US) in patients with shoulder pain and/or disability and to compare the accuracy of both techniques for the detection of partial-thickness and full-thickness rotator cuff tears (RCT). Methods In 4 years, 5,216 patients underwent US by experienced musculoskeletal radiologists. Retrospectively, patient records were evaluated if MRI and surgery were performed within 5 months of US. US and MRI findings were classified into intact cuff, partial-thickness and full-thickness RCT, and were correlated with surgical findings. Results Additional MR imaging was performed in 275 (5.2%) patients. Sixty-eight patients underwent surgery within 5 months. US and MRI correctly depicted 21 (95%) and 22 (100%) of the 22 full-thickness tears, and 8 (89%) and 6 (67%) of the 9 partial-thickness tears, respectively. The differences in performance of US and MRI were not statistically significant (p = 0.15). Conclusions MRI following routine shoulder US was requested in only 5.2% of the patients. The additional value of MRI was in detecting intra-articular lesions. In patients who underwent surgery, US and MRI yielded comparably high sensitivity for detecting full-thickness RCT. US performed better in detecting partial-thickness tears, although the difference was not significant.
Journal of orthopaedic surgery and research, 2017
Rotator cuff tears are very common and their incidence increases with age. Shoulder ultrasonography has recently gained popularity in detecting rotator cuff tears because of its efficiency, cost-effectiveness, time-saving, and real-time nature of the procedure. Well-trained orthopedic surgeons may utilize shoulder ultrasonography to diagnose rotator cuff tears. The wait time of patients planned to have shoulder MRI (magnetic resonance imaging) to rule in rotator cuff tears may decrease after orthopedic surgeon start doing shoulder ultrasonography as a screening tool for that. Patients with rotator cuff tears may be detected earlier by ultrasonography and have expedited surgical repair. The efficacy in determination of rotator cuff tears will also increase. Patients were retrospectively reviewed from January 2007 to December 2012. They were divided into 2 groups: Ultrasound (-) group and the Ultrasound (+) group. Age, gender, wait time from outpatient department (OPD) visit to MRI ex...
Diagnostic imaging of shoulder rotator cuff lesions
Acta Ortopédica Brasileira, 2002
Shoulder rotator cuff tendon tears were evaluated with ultrasonography (US) and magnetic resonance imaging (MRI). Surgical or arthroscopical correlation were available in 25 cases. Overall costs were also considered. Shoulder impingement syndrome diagnosis was done on a clinical basis. Surgery or arthroscopy was considered when conservative treatment failure for 6 months, or when rotator cuff repair was indicated. Ultrasound was performed in 22 patients and MRI in 17 of the 25 patients. Sensitivity, specificity and accuracy were 80%, 100% and 90.9% for US and 90%, 100% and 94.12% for MRI, respectively. In 16 cases both US and MRI were obtained and in this subgroup statistical correlation was excellent (p< 0.001). We concluded that both methods are reliable for rotator cuff full thickness tear evaluation. Since US is less expensive, it could be considered as the screening method when rotator cuff integrity is the main question, and when well trained radiologists and high resolution equipment are available.
The American Journal of Sports Medicine, 1992
In this study we assessed the clinical usefulness of ultrasonography as a modality in the diagnosis of rota tor cuff tears. One hundred twenty patients with pre operative ultrasonography were analyzed by diagnostic arthroscopy to evaluate rotator cuff integrity. Two groups, 61 patients with a positive ultrasonogram and 59 patients with a negative ultrasonogram, were ana lyzed. The 61 patients with a positive ultrasonogram preoperatively were found to have 42 full-thickness tears and 19 partial-thickness tears. Diagnostic arthros copy confirmed a sensitivity of 95% for the full-thick ness tears and 41 % for the partial-thickness tears. In the 59 patients with negative ultrasonography, the specificity for full-thickness tears was 93% and in the 19 partial-thickness tears it was 91 %. Our conclusion is that ultrasonography is an effective modality for the assessment of full-thickness tears, but not partial-thick ness tears.
Correlation between High Resolution Ultrasonography and MRI in Rotator Cuff Tear Diagnosis
International Journal of Health Sciences and Research, 2014
Context: Rotator cuff tears is an important cause of shoulder pain and MRI is limited by it cost and availability especially in the developing countries. Aims: This study was undertaken to find the degree of agreement between MRI and high resolution Ultrasonography in the diagnosis of Rotator cuff tears (RCT). Methods and Material: Fifty consecutive patients with shoulder pain who were clinically suspected of RCT underwent ultrasonography and subsequent MRI was done. According to standardized procedures, Sonography was performed by a radiologist. USG and MRI results were scored as negative or positive for the presence of a full-thickness and partial thickness RCT. Statistical analysis: The agreement between the two methods was assessed using kappa coefficient. Results: Out of 50 patients, a total of 34 patients were diagnosed as having rotator cuff tears on ultrasound while 16 patients were normal. When MRI examination was conducted in these patients, it showed 38 cases of rotator cuff tears while 12 patients were diagnosed as normal. The agreement between the two methods was assessed using kappa coefficient. The strength of agreement between USG and MRI for the diagnosis of rotator cuff tears was found to be 'very good'. Conclusions: Out of 50 patients, a total of 34 patients were diagnosed as having rotator cuff tears on ultrasound while 16 patients were normal. When MRI examination was conducted in these patients, it showed 38 cases of rotator cuff tears while 12 patients were diagnosed as normal. The agreement between the two methods was assessed using kappa coefficient. The strength of agreement between USG and MRI for the diagnosis of rotator cuff tears was found to be 'very good.
Role of Magnetic Resonance Imaging in the Evaluation of Rotator Cuff Tears
Cureus, 2022
Background Magnetic resonance imaging (MRI), with the advent of surface coils, is becoming the modality of choice for imaging soft tissues around the shoulder joint. Good knowledge regarding the MR characteristics of rotator cuff tendons, acromion, and the abnormalities in these tendons is necessary for appropriate diagnosis. Methods This was a hospital-based descriptive, analytical and prospective study conducted at our tertiary care hospital. The study was performed on 50 patients with rotator cuff lesions detected on MRI of the shoulder joint. Results The age distribution found in the study is between 19 and 66 years with mean being 43 ± 14.8 years. The peak incidence was found in the fifth and sixth decades of life. Gender-wise distribution of rotator cuff pathologies has shown no significant gender variation. The pain was the most common presenting complaint. An abnormal supraspinatus tendon was seen in 82% of the 50 study patients, making it the most commonly affected tendons, followed by subscapularis and infraspinatus tendons. No apparent teres minor pathology was identified in the study patients. The most common pathology affecting the supraspinatus tendon was tendinosis (38%) closely followed by a partial tear (36%). Among the partial tears, the articular surface type of tear was the most common. About 52% patients had type II (curved) acromion; making it the most common type of acromion followed by type III (hook), supraspinatus tendinopathy was more common in type II acromion. A reduction in the acromiohumeral distance can cause supraspinatus tendinosis and also makes it more susceptible to tear. About 45.5% showed supraspinatus tendon tears when the acromiohumeral distance was less than 8mm as compared to 13.6% when more than 10mm. Only 4.2% had normal supraspinatus tendon in patients with this distance less than 7mm. Conclusion MRI provides valuable information to the orthopaedic surgeon regarding the status of tendons, bones, and joints. In order to choose the appropriate course of action, it is crucial first to identify the issue and report relevant data from rotator cuff imaging. A full grasp of the rotator cuff's architecture and function, as well as the repercussions of rotator cuff diseases, is required.